Provider Demographics
NPI:1225637143
Name:MEADOWS-KENNDY, CARRIE ANN
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:MEADOWS-KENNDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:WV
Mailing Address - Zip Code:24866-0092
Mailing Address - Country:US
Mailing Address - Phone:276-970-5122
Mailing Address - Fax:
Practice Address - Street 1:164 COLLINS BOTTOM RD
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:WV
Practice Address - Zip Code:24866
Practice Address - Country:US
Practice Address - Phone:276-970-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant