Healthcare Provider Details

I. General information

NPI: 1568109973
Provider Name (Legal Business Name): NANETTE IRENE MEADOWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 VARNUM ST NE STE 21
WASHINGTON DC
20017-2106
US

IV. Provider business mailing address

1160 VARNUM ST NE STE 21
WASHINGTON DC
20017-2106
US

V. Phone/Fax

Practice location:
  • Phone: 202-525-1448
  • Fax: 202-621-8924
Mailing address:
  • Phone: 202-525-1448
  • Fax: 202-621-8924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: