Provider Demographics
NPI:1750570545
Name:MEADOR, RONALD DWAYNE (FNP-C)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:DWAYNE
Last Name:MEADOR
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7294
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-7294
Mailing Address - Country:US
Mailing Address - Phone:254-855-6952
Mailing Address - Fax:
Practice Address - Street 1:6250 US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5215
Practice Address - Country:US
Practice Address - Phone:325-428-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily