Provider Demographics
NPI:1619140175
Name:MEADE, DORINE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:DORINE
Middle Name:ANN
Last Name:MEADE
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 1:6950 LEVANT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6010
Mailing Address - Country:US
Mailing Address - Phone:858-694-5428
Mailing Address - Fax:858-694-5375
Practice Address - Street 1:6950 LEVANT ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6010
Practice Address - Country:US
Practice Address - Phone:858-694-5428
Practice Address - Fax:858-694-5375
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA262015163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse