Individual
MISS MEGHAN MARIE MADEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, NP
Contact information
Practice address
2500 PERES AVE, MEMPHIS, TN 38108-1660
(901) 515-5500
(901) 458-5591
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-8336
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
0064
MP
367A00000X
Advanced Practice Midwife
Primary
16959
TN
Other
Enumeration date
02/04/2008
Last updated
12/03/2014
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