Basic Information
Provider Information
NPI: 1700966009
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEEKS
FirstName: MARTHA
MiddleName: E
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MEEKS
OtherFirstName: BETSY
OtherMiddleName:  
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 5
Mailing Information
Address1: 2931 E BIDDLE ST
Address2: PATIENT ACCOUNTING
City: BALTIMORE
State: MD
PostalCode: 212133939
CountryCode: US
TelephoneNumber: 4439231886
FaxNumber: 4439231875
Practice Location
Address1: 1920 BRIARCLIFF RD NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303294010
CountryCode: US
TelephoneNumber: 4044194000
FaxNumber: 4044194505
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN072001GAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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