Provider Demographics
NPI:1881319549
Name:CARR, MEREDITH CAROLINE (PA-C)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CAROLINE
Last Name:CARR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 CREST DR
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1408
Mailing Address - Country:US
Mailing Address - Phone:724-757-1252
Mailing Address - Fax:
Practice Address - Street 1:600 OXFORD DR STE 200
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2355
Practice Address - Country:US
Practice Address - Phone:412-858-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063895363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant