Provider Demographics
NPI:1629064167
Name:MEEKS, JANICE (CRNA)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 NOAH DR
Mailing Address - Street 2:STE 113-315
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-8705
Mailing Address - Country:US
Mailing Address - Phone:706-301-1098
Mailing Address - Fax:706-301-9151
Practice Address - Street 1:515 HIGHWAY 515 S
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-8655
Practice Address - Country:US
Practice Address - Phone:706-692-2441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN093685367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00074Z013DMedicaid
GA000742013GMedicaid
GA968115OtherBCBS PROVIDER NUM
GA968115OtherBCBS PROVIDER NUM
GA00074Z013DMedicaid