Provider Demographics
NPI:1689258097
Name:TOMS, MEREDITH ROSE (APRN)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ROSE
Last Name:TOMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE STREET 4TH FLOOR WING D
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-5643
Mailing Address - Fax:859-323-3795
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:STE L404
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-5643
Practice Address - Fax:859-323-3795
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY201914782363LP0200X
KY3016077363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics