Provider Demographics
NPI:1144728031
Name:MEEKS, MONICA (NP)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:SISSOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:51 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:GRUETLI LAAGER
Mailing Address - State:TN
Mailing Address - Zip Code:37339-5319
Mailing Address - Country:US
Mailing Address - Phone:931-808-5369
Mailing Address - Fax:931-808-5369
Practice Address - Street 1:51 61ST AVE
Practice Address - Street 2:
Practice Address - City:GRUETLI LAAGER
Practice Address - State:TN
Practice Address - Zip Code:37339-5319
Practice Address - Country:US
Practice Address - Phone:931-808-5369
Practice Address - Fax:931-808-5369
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF01181108363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner