Provider Demographics
NPI:1659878387
Name:ZHAO, MEIRU (FNP)
Entity type:Individual
Prefix:
First Name:MEIRU
Middle Name:
Last Name:ZHAO
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 S HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2408
Mailing Address - Country:US
Mailing Address - Phone:610-205-1264
Mailing Address - Fax:
Practice Address - Street 1:2400 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2431
Practice Address - Country:US
Practice Address - Phone:302-317-1531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0053872163W00000X
DELG-0001259363L00000X, 363LF0000X
PASP018513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAYXQ123196725001OtherKEYSTONE PLAN EAST