Provider Demographics
NPI:1598122715
Name:VEAZEY, MEREDITH KRONN
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:KRONN
Last Name:VEAZEY
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 1:24411 HEALTH CENTER DR STE 620
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3672
Mailing Address - Country:US
Mailing Address - Phone:949-521-6060
Mailing Address - Fax:949-521-6063
Practice Address - Street 1:1700 SPRING HILL AVE STE 100
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1416
Practice Address - Country:US
Practice Address - Phone:251-435-1200
Practice Address - Fax:251-435-6357
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53145363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant