Provider Demographics
NPI:1922668045
Name:MEEKS, ELISE JEANNE (FNP-C)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:JEANNE
Last Name:MEEKS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:JEANNE
Other - Last Name:COLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:690 S LOOP 336 W
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3319
Mailing Address - Country:US
Mailing Address - Phone:936-828-3962
Mailing Address - Fax:
Practice Address - Street 1:690 S LOOP 336 W
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3319
Practice Address - Country:US
Practice Address - Phone:936-828-3962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN270340363LF0000X, 163W00000X
TX662914163W00000X
TX1142371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse