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General NPI Number Information
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NPI Number | 1578558185
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Entity Type | Individual
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Provider Name | WILLARD SCOTT MEADOWS CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 704 HWY 70 E
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City | DICKSON
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State | TN
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Zip | 37055-2111
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Country | US
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Telephone | 615-620-2320
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Fax | 615-620-2323
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Provider Business Mailing Address
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Address Line | PO BOX 299
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City | MANCHESTER
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State | TN
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Zip | 37349-0299
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Country | US
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Telephone | 931-728-5607
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Fax | 931-728-8354
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP5193A
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License Number State | KY
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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 | APN10816
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN106855
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License Number State | TN
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