Provider Demographics
NPI:1376953919
Name:CROY, MEREDITH H (NP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:H
Last Name:CROY
Suffix:
Gender:F
Credentials:NP
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 602120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2120
Mailing Address - Country:US
Mailing Address - Phone:980-442-2000
Mailing Address - Fax:704-355-5800
Practice Address - Street 1:1021 MOREHEAD MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2839
Practice Address - Country:US
Practice Address - Phone:980-442-2000
Practice Address - Fax:704-355-5800
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC229213363L00000X, 363LF0000X
NCCROY-774NKT363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1376953919Medicaid
SCNP2830Medicaid
NCNCK171AMedicare PIN