Healthcare Provider Details

I. General information

NPI: 1578295317
Provider Name (Legal Business Name): MEREDITH MCREE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6730 ROOSEVELT AVE STE 303
MIDDLETOWN OH
45005-0017
US

IV. Provider business mailing address

PO BOX 229
MIAMISBURG OH
45343-0229
US

V. Phone/Fax

Practice location:
  • Phone: 513-874-0486
  • Fax: 513-280-8868
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008759RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: