Provider Demographics
NPI:1578683009
Name:MEEHAN, CAROLINE ELIZABETH (RN)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 PICCADILLY CIR
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3163
Mailing Address - Country:US
Mailing Address - Phone:239-283-4026
Mailing Address - Fax:239-283-4126
Practice Address - Street 1:1926 PICCADILLY CIR
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3163
Practice Address - Country:US
Practice Address - Phone:239-283-4026
Practice Address - Fax:239-283-4126
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9162489163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN91522489OtherREGISTERED NURSE