Provider Demographics
NPI:1528234705
Name:HAKE, MEREDITH MCCOY (RN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:MCCOY
Last Name:HAKE
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Gender:F
Credentials:RN, PMHNP-BC
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Mailing Address - Street 1:2300 HIGHLAND VILLAGE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7191
Mailing Address - Country:US
Mailing Address - Phone:972-966-1076
Mailing Address - Fax:972-767-0755
Practice Address - Street 1:2300 HIGHLAND VILLAGE RD STE 210
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7191
Practice Address - Country:US
Practice Address - Phone:972-966-1079
Practice Address - Fax:972-767-0755
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2024-02-07
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX678614363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health