Provider Demographics
NPI:1457352742
Name:MERIDETH, BARBARA WARD (RN, CS, FNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:WARD
Last Name:MERIDETH
Suffix:
Gender:F
Credentials:RN, CS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 COUNTY HIGHWAY 534
Mailing Address - Street 2:
Mailing Address - City:CARUTHERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63830-9170
Mailing Address - Country:US
Mailing Address - Phone:573-333-2654
Mailing Address - Fax:
Practice Address - Street 1:106 W 12TH ST
Practice Address - Street 2:
Practice Address - City:CARUTHERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63830-1890
Practice Address - Country:US
Practice Address - Phone:573-333-1784
Practice Address - Fax:573-333-4665
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR22173Medicare UPIN