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General NPI Number Information
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NPI Number | 1104734623
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Entity Type | Individual
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Provider Name | SPENCER D MEEKS AGPCNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 300 E WASHINGTON BLVD
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City | FORT WAYNE
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State | IN
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Zip | 46802-3124
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Country | US
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Telephone | 260-422-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CABARRUS AVE E STE 20
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City | CONCORD
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State | NC
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Zip | 28025-3699
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Country | US
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Telephone | 844-932-5700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 71018580A
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License Number State | IN
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