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Individual

CRAIG A MEILUTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN CASE MANAGEMENT

Contact information

Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8242
(270) 956-0223
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8242
(270) 956-0223

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
217984
TX
164X00000X
Licensed Vocational Nurse
217984
TX

Other

Enumeration date
05/23/2023
Last updated
05/23/2023
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