Provider Demographics
NPI:1477161065
Name:MEEKS, SHARON MARIE
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:MEEKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MAPLE HILL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847-1547
Mailing Address - Country:US
Mailing Address - Phone:304-257-9298
Mailing Address - Fax:
Practice Address - Street 1:12 MAPLE HILL AVE
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-1547
Practice Address - Country:US
Practice Address - Phone:304-257-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374U00000X
WV374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty