Provider Demographics
NPI:1407181936
Name:MEEHAN, PATRICK MICHAEL (RN)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:MEEHAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 DEL PRADO BLVD S UNIT 2-152
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5788
Mailing Address - Country:US
Mailing Address - Phone:239-283-4026
Mailing Address - Fax:239-283-4126
Practice Address - Street 1:2710 DEL PRADO BLVD S UNIT 2-152
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5788
Practice Address - Country:US
Practice Address - Phone:239-910-8764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLEMT300311146N00000X
FLRN9162385163WA2000X, 163WH1000X
FLRPT35994183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No183700000XPharmacy Service ProvidersPharmacy Technician