Provider Demographics
NPI:1770180358
Name:MEADOWS, STEPHANIE L
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 STATE ROUTE 3 AND 12
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-5064
Mailing Address - Country:US
Mailing Address - Phone:304-445-8384
Mailing Address - Fax:
Practice Address - Street 1:1837 STATE ROUTE 3 AND 12
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-5064
Practice Address - Country:US
Practice Address - Phone:304-445-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant