Basic Information
Provider Information
NPI: 1871908012
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDERSON
FirstName: MEREDITH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AU.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPT OF OHNS UNC AT CHAPEL HILL 170 MANNING DR
Address2: POB G190, CB7070
City: CHAPEL HILL
State: NC
PostalCode: 275997070
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: DEPT OF OHNS UNC AT CHAPEL HILL 170 MANNING DR
Address2: POB G190, CB7070
City: CHAPEL HILL
State: NC
PostalCode: 275997070
CountryCode: US
TelephoneNumber: 9199665251
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2014
LastUpdateDate: 06/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X10916 Y Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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