Healthcare Provider Details

I. General information

NPI: 1134421134
Provider Name (Legal Business Name): MRS. LINDA MORRIS MEADOWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5630 MOUNT PLEASANT RD S
CONCORD NC
28025-7669
US

IV. Provider business mailing address

5630 MOUNT PLEASANT RD S
CONCORD NC
28025-7669
US

V. Phone/Fax

Practice location:
  • Phone: 704-723-9354
  • Fax:
Mailing address:
  • Phone: 704-723-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number151240
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number85709
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: