Provider Demographics
NPI:1205281680
Name:MEADOWS, AMANDA (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4934
Mailing Address - Country:US
Mailing Address - Phone:925-783-3338
Mailing Address - Fax:
Practice Address - Street 1:5455 WALNUT LN
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4934
Practice Address - Country:US
Practice Address - Phone:925-783-3338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA798871163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics