Provider Demographics
NPI:1922805944
Name:MEADS, MICHELLE R
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:R
Last Name:MEADS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 WEST ELM AVE
Mailing Address - Street 2:
Mailing Address - City:ELM CREEK
Mailing Address - State:NE
Mailing Address - Zip Code:68836
Mailing Address - Country:US
Mailing Address - Phone:308-440-1945
Mailing Address - Fax:
Practice Address - Street 1:612 WEST ELM AVE
Practice Address - Street 2:
Practice Address - City:ELM CREEK
Practice Address - State:NE
Practice Address - Zip Code:68836
Practice Address - Country:US
Practice Address - Phone:308-440-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant