Provider Demographics
NPI:1487544730
Name:MEADOWS, TRYSTAN RAIN
Entity type:Individual
Prefix:
First Name:TRYSTAN
Middle Name:RAIN
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRYSTAN
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 W WILLIAM AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-0026
Mailing Address - Country:US
Mailing Address - Phone:308-568-3580
Mailing Address - Fax:
Practice Address - Street 1:625 W WILLIAM AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-0026
Practice Address - Country:US
Practice Address - Phone:308-568-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health