Provider Demographics
NPI:1740899202
Name:MEEHAN, VICTORIA WHEELER (CNA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:WHEELER
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HARLAN ST # 58
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-2358
Mailing Address - Country:US
Mailing Address - Phone:303-550-9818
Mailing Address - Fax:
Practice Address - Street 1:701 HARLAN ST # 58
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-2358
Practice Address - Country:US
Practice Address - Phone:303-550-9818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONA00777765376K00000X
CONA.00777765376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide