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General NPI Number Information
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NPI Number | 1194131979
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Entity Type | Organization
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Legal Business Name | MERIDIAN ADULT HEALTH PC
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 9002 N MERIDIAN ST LOWER LEVEL
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5381
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Country | US
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Telephone | 574-268-9640
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Fax |
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Provider Business Mailing Address
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Address Line | 15272 KAMPEN CIR
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City | CARMEL
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State | IN
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Zip | 46033-0002
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Country | US
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Telephone | 574-268-9640
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Fax |
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Authorized Official
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Title or Position | CRNA
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Name | JACQUELINE S ROWLES
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Credential | CRNA ANP BC
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Telephone | 317-694-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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