Provider Demographics
NPI:1720705122
Name:WEST, MEREDITH (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 W BALTIMORE PIKE STE 2403
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5166
Mailing Address - Country:US
Mailing Address - Phone:484-444-2151
Mailing Address - Fax:
Practice Address - Street 1:1088 W BALTIMORE PIKE STE 2403
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5166
Practice Address - Country:US
Practice Address - Phone:484-444-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026515363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health