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NPI Code Detail

MEDICARE: MRS. MEREDITH ELLA CARTER

MEDICARE: MRS. MEREDITH ELLA CARTER
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
1225X00000XOccupational Therapist2002016485MO

General Provider Information

NPI Number : 1922176296
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEREDITH ELLA CARTER
Provider Business Mailing Address
First Line : 5088 AQUA DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3203
Country : US
Telephone Number : 314-623-6081
Fax Number :
Provider Business Practice Location Address
First Line : 5088 AQUA DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3203
Country : US
Telephone Number : 314-623-6081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. MEREDITH ELLA CARTER ” Practice Location

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