Provider Demographics
NPI:1346337003
Name:MEEKS, DENISE DAVIDSON (CNM)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:DAVIDSON
Last Name:MEEKS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 RED SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BRUTUS
Mailing Address - State:MI
Mailing Address - Zip Code:49716-9708
Mailing Address - Country:US
Mailing Address - Phone:231-539-8303
Mailing Address - Fax:
Practice Address - Street 1:2810 CHARLEVOIX AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8421
Practice Address - Country:US
Practice Address - Phone:231-487-0970
Practice Address - Fax:231-487-0979
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704187704367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife