Provider Demographics
NPI:1144397563
Name:LASHWAY, MERIDITH A (MS, RD, LD, CDE)
Entity type:Individual
Prefix:MS
First Name:MERIDITH
Middle Name:A
Last Name:LASHWAY
Suffix:
Gender:F
Credentials:MS, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WILLOW WINDS PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7300
Mailing Address - Country:US
Mailing Address - Phone:904-229-7175
Mailing Address - Fax:
Practice Address - Street 1:4555 EMERSON ST STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4958
Practice Address - Country:US
Practice Address - Phone:904-633-0098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006032648133V00000X
FLND4704133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCS357ZMedicare PIN
MO835410051Medicare PIN
FLP00820983Medicare PIN