Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 105467 | CA |
NPI | 1326604364 |
---|---|
Provider Name | Dr. Karen Ashley Merriweather |
First Address | Fresno, CA 93711-0795 |
Second Address | Mendota, CA 93640-1901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 02/10/2020 |