Provider Demographics
NPI:1518554187
Name:MEADOWS, DEBORAH K
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:MEADOWS
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 1:241 EASTRUN RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26571-8210
Mailing Address - Country:US
Mailing Address - Phone:304-825-6841
Mailing Address - Fax:
Practice Address - Street 1:15 FREEMAN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26571-8007
Practice Address - Country:US
Practice Address - Phone:130-461-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant