Provider Demographics
NPI:1790965614
Name:MEADOWS, DEBRA ANN (DC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:113 FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:NASHWAUK
Mailing Address - State:MN
Mailing Address - Zip Code:55769-1103
Mailing Address - Country:US
Mailing Address - Phone:218-885-2070
Mailing Address - Fax:218-885-2070
Practice Address - Street 1:113 FIRST STREET
Practice Address - Street 2:
Practice Address - City:NASHWAUK
Practice Address - State:MN
Practice Address - Zip Code:55769-1103
Practice Address - Country:US
Practice Address - Phone:218-885-2070
Practice Address - Fax:218-885-2070
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN003725700Medicaid