Provider Demographics
NPI:1649635269
Name:MEEKS, FELICIA
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:MEEKS
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 1:5 LOYALIST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-4948
Mailing Address - Country:US
Mailing Address - Phone:585-410-3936
Mailing Address - Fax:
Practice Address - Street 1:5 LOYALIST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-4948
Practice Address - Country:US
Practice Address - Phone:585-410-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-25
Last Update Date:2015-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324140164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse