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Individual

MEREDITH J ETHERIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
225 MEDICAL CENTER DR STE 304, PADUCAH, KY 42003-7915
(270) 538-5596
Mailing address
225 MEDICAL CENTER DR STE 304, PADUCAH, KY 42003-7915
(270) 538-5596

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3005182
KY
363L00000X
Nurse Practitioner
5182P
KY
363LF0000X
Family Nurse Practitioner
Primary
3005182
KY
363LP0200X
Pediatric Nurse Practitioner
5182P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100062510
KY
01
K245300
MEDICARE PTAN
KY
Enumeration date
03/21/2008
Last updated
09/30/2025
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