Provider Demographics
NPI:1700167285
Name:BAXTER, MERIDETH ASHLEIGH (R EEG T)
Entity Type:Individual
Prefix:
First Name:MERIDETH
Middle Name:ASHLEIGH
Last Name:BAXTER
Suffix:
Gender:F
Credentials:R EEG T
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Mailing Address - Street 1:3292 LOMBARDY LN APT C
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520-7708
Mailing Address - Country:US
Mailing Address - Phone:970-623-3544
Mailing Address - Fax:
Practice Address - Street 1:2635 N 7TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8209
Practice Address - Country:US
Practice Address - Phone:970-298-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4702246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic