Provider Demographics
NPI:1306420195
Name:MEACHAM, ELIZABETH VAUGHN (FNP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:VAUGHN
Last Name:MEACHAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 BROWNSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8376
Mailing Address - Country:US
Mailing Address - Phone:256-698-2802
Mailing Address - Fax:
Practice Address - Street 1:450 LANIER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1866
Practice Address - Country:US
Practice Address - Phone:256-817-5970
Practice Address - Fax:256-817-5971
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF01210318363LF0000X
AL1-116201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily