Provider Demographics
NPI:1114379625
Name:MEADOWS, CASSIE JEANETTE (FNP)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:JEANETTE
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BOONE RIDGE DR
Mailing Address - Street 2:STE 201
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-8000
Mailing Address - Country:US
Mailing Address - Phone:423-282-1480
Mailing Address - Fax:423-928-1353
Practice Address - Street 1:151 WENDOVER DR
Practice Address - Street 2:UNIT 5
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2655
Practice Address - Country:US
Practice Address - Phone:423-239-0099
Practice Address - Fax:423-239-0273
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNRN0000186618163W00000X
TN21373363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse