Healthcare Provider Details

I. General information

NPI: 1467570366
Provider Name (Legal Business Name): MEREDITH A. YEAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W TYRONE RD
OAK RIDGE TN
37830-6517
US

IV. Provider business mailing address

240 W TYRONE RD
OAK RIDGE TN
37830-6517
US

V. Phone/Fax

Practice location:
  • Phone: 865-482-1076
  • Fax: 865-481-6179
Mailing address:
  • Phone: 865-482-1076
  • Fax: 865-481-6179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: