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NPI Code Detail

MEDICARE: MRS. SAMANTHA ASHLEY MEESON NP-C

MEDICARE: MRS. SAMANTHA ASHLEY MEESON NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerCOA.17212-NPOH
2363LG0600XGerontology Nurse PractitionerCOA.17212-NPOH

General Provider Information

NPI Number : 1043698780
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SAMANTHA ASHLEY MEESON NP-C
Provider Business Mailing Address
First Line : 11100 EUCLID AVE
Second Line : LKS 5047
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-1755
Fax Number : 216-844-2888
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line : LKS 5047
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-1755
Fax Number : 216-844-2888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2015
Last Update Date : 05/14/2015

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