MEDICARE: SAMANTHA MEADOR

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	163W00000X	Registered Nurse	2025048489	MO

General Provider Information

NPI Number	:	1326906504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA MEADOR

Provider Business Mailing Address
First Line	:	405 PALERMO DR
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63021-6420
Country	:	US
Telephone Number	:	314-299-2971
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 PALERMO DR
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63021-6420
Country	:	US
Telephone Number	:	314-299-2971
Fax Number	:

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ SAMANTHA MEADOR ” Practice Location

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