Provider Demographics
NPI:1255691275
Name:CARMICHAEL, MEREDITH (RN)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 STURBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ERIAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-9603
Mailing Address - Country:US
Mailing Address - Phone:856-912-8123
Mailing Address - Fax:
Practice Address - Street 1:16 STURBRIDGE DR
Practice Address - Street 2:
Practice Address - City:ERIAL
Practice Address - State:NJ
Practice Address - Zip Code:08081-9603
Practice Address - Country:US
Practice Address - Phone:856-912-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00417200367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered