Provider Demographics
NPI:1689960627
Name:MEEKER, JOHN ROBERT (RN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:MEEKER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 SAM RITTENBERG BLVD
Mailing Address - Street 2:APT 1616
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4826
Mailing Address - Country:US
Mailing Address - Phone:609-254-7982
Mailing Address - Fax:
Practice Address - Street 1:1916 SAM RITTENBERG BLVD
Practice Address - Street 2:APT 1616
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4826
Practice Address - Country:US
Practice Address - Phone:609-254-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC102897163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice