Provider Demographics
NPI:1154207322
Name:VANCE, MEREDITH TAYLOR (PHARMD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:TAYLOR
Last Name:VANCE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 LAKELAND EAST DR STE B
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9565
Mailing Address - Country:US
Mailing Address - Phone:769-230-8335
Mailing Address - Fax:769-230-8337
Practice Address - Street 1:630 LAKELAND EAST DR STE B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9565
Practice Address - Country:US
Practice Address - Phone:769-230-8335
Practice Address - Fax:769-230-8337
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-12710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist