MEDICARE: MRS. JUDITH ANN MEEK CPNP

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
1	363LP0200X	Pediatric Nurse Practitioner	209007638	IL

General Provider Information

NPI Number	:	1124007117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUDITH ANN MEEK CPNP

Provider Business Mailing Address
First Line	:	2810 FRANK SCOTT PKWY W STE 950
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-5007
Country	:	US
Telephone Number	:	618-233-3205
Fax Number	:	618-233-1407

Provider Business Practice Location Address
First Line	:	2810 FRANK SCOTT PKWY W STE 950
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-5007
Country	:	US
Telephone Number	:	618-233-3205
Fax Number	:	618-233-1407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	12/19/2023

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