Provider Demographics
NPI:1952101339
Name:MEADOWS, DORIE LYNN (AMT,HHA,MA)
Entity type:Individual
Prefix:
First Name:DORIE
Middle Name:LYNN
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:AMT,HHA,MA
Other - Prefix:
Other - First Name:DORIE
Other - Middle Name:LYNN
Other - Last Name:MARKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 S 22ND ST APT 502
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-3028
Mailing Address - Country:US
Mailing Address - Phone:402-487-5170
Mailing Address - Fax:
Practice Address - Street 1:604 S 22ND ST APT 502
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-3028
Practice Address - Country:US
Practice Address - Phone:402-487-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3039672363A00000X
NE3039672363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3039672OtherAMT
TN3039672OtherAMT