Provider Demographics
NPI:1871381715
Name:SINGH, MEERA
Entity type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:SINGH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E DORTON BLVD
Mailing Address - Street 2:
Mailing Address - City:STAFFORDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41256-9128
Mailing Address - Country:US
Mailing Address - Phone:678-768-4282
Mailing Address - Fax:
Practice Address - Street 1:505 PRISON CONNECTOR
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171-7010
Practice Address - Country:US
Practice Address - Phone:606-738-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4036572363LF0000X
GA2024103316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily