Provider Demographics
NPI:1346672326
Name:MEADE, CAROLIE (NP)
Entity Type:Individual
Prefix:
First Name:CAROLIE
Middle Name:
Last Name:MEADE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAROLIE
Other - Middle Name:
Other - Last Name:VOSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:644 EDEN PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202
Mailing Address - Country:US
Mailing Address - Phone:813-289-9613
Mailing Address - Fax:484-253-1790
Practice Address - Street 1:644 EDEN PARK DRIVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202
Practice Address - Country:US
Practice Address - Phone:813-289-9613
Practice Address - Fax:484-253-1790
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP 14299363LA2200X
OHNP14299363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2012022736OtherANCC CERTIFICATION NUMBER
OHNP 14299OtherOHIO LICENSE