Provider Demographics
NPI:1295136588
Name:MEADOWS, KATHY (APRN-BC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 HINTON BYP
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-9184
Mailing Address - Country:US
Mailing Address - Phone:304-309-4143
Mailing Address - Fax:304-309-4146
Practice Address - Street 1:158 HINTON BYP
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-9184
Practice Address - Country:US
Practice Address - Phone:304-309-4143
Practice Address - Fax:304-309-4146
Is Sole Proprietor?:No
Enumeration Date:2014-09-06
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1295136588Medicaid