Provider Demographics
NPI:1356468581
Name:MEINHARDT, VICKI (CPM)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:MEINHARDT
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W JOHANNA ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4229
Mailing Address - Country:US
Mailing Address - Phone:512-448-4203
Mailing Address - Fax:512-416-8494
Practice Address - Street 1:107 W JOHANNA ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4229
Practice Address - Country:US
Practice Address - Phone:512-448-4203
Practice Address - Fax:512-416-8494
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05008176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife