Provider Demographics
NPI:1588208359
Name:MEEKER, CAROLYN AILEEN
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:AILEEN
Last Name:MEEKER
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 1:2316 HARVEST MOON LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-4985
Mailing Address - Country:US
Mailing Address - Phone:317-947-7098
Mailing Address - Fax:
Practice Address - Street 1:2316 HARVEST MOON LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-4985
Practice Address - Country:US
Practice Address - Phone:317-947-7098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer