Provider Demographics
NPI:1861444531
Name:MEADOWS, RHONDA NICKIE (PA C)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:NICKIE
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0280
Mailing Address - Country:US
Mailing Address - Phone:606-349-8100
Mailing Address - Fax:606-349-8150
Practice Address - Street 1:960 E MT PARKWAY
Practice Address - Street 2:ALBAREE HEALTH SERVICE
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465
Practice Address - Country:US
Practice Address - Phone:606-349-8100
Practice Address - Fax:606-349-8150
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA815363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95005054Medicaid
KYQ20780Medicare UPIN
KY536710Medicare ID - Type Unspecified