Provider Demographics
NPI:1760287643
Name:MEACHAM, ANDREW (RN)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MEACHAM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 HIGHLAND HL
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-8832
Mailing Address - Country:US
Mailing Address - Phone:970-581-9465
Mailing Address - Fax:
Practice Address - Street 1:1382 HIGHLAND HL
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-8832
Practice Address - Country:US
Practice Address - Phone:970-581-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704403264163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse