Provider Demographics
NPI:1134421134
Name:MEADOWS, LINDA MORRIS
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MORRIS
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5630 MOUNT PLEASANT RD S
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-7669
Mailing Address - Country:US
Mailing Address - Phone:704-723-9354
Mailing Address - Fax:
Practice Address - Street 1:5630 MOUNT PLEASANT RD S
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-7669
Practice Address - Country:US
Practice Address - Phone:704-723-9354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC151240163W00000X
NC85709367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8054068Medicaid
SCNAN017Medicaid
SCNAN017Medicaid