Provider Demographics
NPI:1265661797
Name:MEINHARDT, ANGELIQUE CAROLYN (ARNP)
Entity Type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:CAROLYN
Last Name:MEINHARDT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 COX RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-3481
Mailing Address - Country:US
Mailing Address - Phone:704-867-7655
Mailing Address - Fax:
Practice Address - Street 1:750 COX RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3481
Practice Address - Country:US
Practice Address - Phone:704-867-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC230317363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health