Provider Demographics
NPI:1619485703
Name:MEADE, KAITLIN TAYLOR
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:TAYLOR
Last Name:MEADE
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 1:30522 GARNAND DRIVE
Mailing Address - Street 2:C/O EMORY & HENRY COLLEGE
Mailing Address - City:EMORY
Mailing Address - State:VA
Mailing Address - Zip Code:24327
Mailing Address - Country:US
Mailing Address - Phone:276-944-6500
Mailing Address - Fax:
Practice Address - Street 1:30461 GARNAND DRIVE
Practice Address - Street 2:EMORY & HENRY COLLEGE
Practice Address - City:EMORY
Practice Address - State:VA
Practice Address - Zip Code:24327
Practice Address - Country:US
Practice Address - Phone:276-944-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer