Basic Information
Provider Information
NPI: 1174726244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NYE
FirstName: MEREDITH
MiddleName: GAYLORD
NamePrefix:  
NameSuffix:  
Credential: M.S. CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: BOX 3887-DUMC
Address2:  
City: DURHAM
State: NC
PostalCode: 27710
CountryCode: US
TelephoneNumber: 9196846271
FaxNumber:  
Practice Location
Address1: 40 DUKE MEDICINE CIR # 1I
Address2:  
City: DURHAM
State: NC
PostalCode: 277100001
CountryCode: US
TelephoneNumber: 9196843451
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/07/2007
LastUpdateDate: 04/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X7622NCY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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