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NPI Code Detail

MEDICARE: BENJAMIN MEEKS FNP

MEDICARE:   BENJAMIN  MEEKS  FNP
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
1363LF0000XFamily Nurse Practitioner7176TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00102426OTHERTNMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
24077962OTHERTNBLUE CROSSBLUE SHIELD

General Provider Information

NPI Number : 1821025222
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN MEEKS FNP
Provider Business Mailing Address
First Line : 101 MED TECH PKWY
Second Line : SUITE 200
City : JOHNSON CITY
State : TN
Zip : 37604-4007
Country : US
Telephone Number : 423-232-6120
Fax Number :
Provider Business Practice Location Address
First Line : 101 MED TECH PKWY STE 200
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-4001
Country : US
Telephone Number : 423-232-6120
Fax Number : 423-232-6125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 01/12/2024

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