Provider Demographics
NPI:1881456481
Name:MEADOWS, KATHRYN (LVN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9587 SILVEY ST
Mailing Address - Street 2:
Mailing Address - City:QUINLAN
Mailing Address - State:TX
Mailing Address - Zip Code:75474-3724
Mailing Address - Country:US
Mailing Address - Phone:940-642-8661
Mailing Address - Fax:
Practice Address - Street 1:9587 SILVEY ST
Practice Address - Street 2:
Practice Address - City:QUINLAN
Practice Address - State:TX
Practice Address - Zip Code:75474-3724
Practice Address - Country:US
Practice Address - Phone:903-355-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021422164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse