Healthcare Provider Details

I. General information

NPI: 1881517746
Provider Name (Legal Business Name): FELICIA NICOLE MEADOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 CRANBERRY DR
BECKLEY WV
25801-8560
US

IV. Provider business mailing address

107 PERDUE ST
DANIELS WV
25832-9680
US

V. Phone/Fax

Practice location:
  • Phone: 304-250-6404
  • Fax:
Mailing address:
  • Phone: 304-228-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number114249
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: