MEDICARE: ANGELA N MEADOWS RN, MSN, FNP-BC

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	363LF0000X	Family Nurse Practitioner	R872973	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679815609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA N MEADOWS RN, MSN, FNP-BC

Provider Business Mailing Address
First Line	:	2101 HIGHWAY 90
Second Line	:
City	:	GAUTIER
State	:	MS
Zip	:	39553-5340
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720A MEDICAL PARK DR STE 150
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39532-2135
Country	:	US
Telephone Number	:	228-392-7429
Fax Number	:

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

Provider Enumeration Date	:	03/16/2013
Last Update Date	:	07/06/2023

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