Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN135685 | GA |
NPI | 1003302167 |
---|---|
Provider Name | Veronica Meardith |
First Address | Augusta, GA 30906-5515 |
Second Address | Augusta, GA 30906-5515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2018 |
Last Update Date | 02/07/2018 |