MEDICARE: MS. LAURA N MEADOWS D.O.

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	146D00000X	Personal Emergency Response Attendant	C7-0004254	DE
2	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician	0101251212	VA
3	103K00000X	Behavior Analyst	C7-0004254	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	124152671	OTHER	VA	UNITEDHEALTHCARE

General Provider Information

NPI Number	:	1760275689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA N MEADOWS D.O.

Provider Business Mailing Address
First Line	:	9633 10TH BAY ST APT 8
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-1347
Country	:	US
Telephone Number	:	757-698-1379
Fax Number	:

Provider Business Practice Location Address
First Line	:	9633 10TH BAY ST APT 8
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-1347
Country	:	US
Telephone Number	:	757-698-1379
Fax Number	:

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

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	11/19/2025

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