Provider Demographics
NPI:1164269114
Name:MEREDITH, SHONDA DENISE (RN)
Entity type:Individual
Prefix:
First Name:SHONDA
Middle Name:DENISE
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 CHESWICK VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9932
Mailing Address - Country:US
Mailing Address - Phone:614-589-0810
Mailing Address - Fax:
Practice Address - Street 1:188 CHESWICK VILLAGE DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9932
Practice Address - Country:US
Practice Address - Phone:614-589-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.476229163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health