Healthcare Provider Details

I. General information

NPI: 1346672326
Provider Name (Legal Business Name): CAROLIE MEADE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLIE VOSSMAN ANP

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 EDEN PARK DRIVE
CINCINNATI OH
45202
US

IV. Provider business mailing address

644 EDEN PARK DRIVE
CINCINNATI OH
45202
US

V. Phone/Fax

Practice location:
  • Phone: 813-289-9613
  • Fax: 484-253-1790
Mailing address:
  • Phone: 813-289-9613
  • Fax: 484-253-1790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP 14299
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP14299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: