Healthcare Provider Details

I. General information

NPI: 1689150146
Provider Name (Legal Business Name): LISA ANN MEAKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10240 CALUMET AVE
MUNSTER IN
46321-2881
US

IV. Provider business mailing address

9061 HIBISCUS DR
SAINT JOHN IN
46373-0150
US

V. Phone/Fax

Practice location:
  • Phone: 219-703-2420
  • Fax: 219-703-6765
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28215674A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28215674A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: