Provider Demographics
NPI:1679389985
Name:MEATCHEM, KEASIA MICHELLE
Entity type:Individual
Prefix:
First Name:KEASIA
Middle Name:MICHELLE
Last Name:MEATCHEM
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 1:5470 BEECHMONT AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-1119
Mailing Address - Country:US
Mailing Address - Phone:513-596-4091
Mailing Address - Fax:
Practice Address - Street 1:5470 BEECHMONT AVE APT 10
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-1119
Practice Address - Country:US
Practice Address - Phone:513-596-4091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health