Provider Demographics
NPI:1720634397
Name:CARR, MEREDITH (APRN)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 PEACH ORCHARD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3531
Mailing Address - Country:US
Mailing Address - Phone:706-792-5057
Mailing Address - Fax:
Practice Address - Street 1:3121 PEACH ORCHARD RD STE 103
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3531
Practice Address - Country:US
Practice Address - Phone:706-792-5057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN220163363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care