Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CPM0000000013 | TN |
NPI | 1134266539 |
---|---|
Provider Name | Mrs. Susan Reine Meeks |
First Address | Franklin, TN 37064-9482 |
Second Address | Franklin, TN 37064-9482 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3149014 | BLUE CROSS BLUE SHIELD (01) | TN |