Healthcare Provider Details

I. General information

NPI: 1629057898
Provider Name (Legal Business Name): BARBARA JO MEEK-THUE R.N. C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 W FOUNTAIN ST
ALBERT LEA MN
56007-2437
US

IV. Provider business mailing address

610 EDGEWOOD AVE
ALBERT LEA MN
56007-3807
US

V. Phone/Fax

Practice location:
  • Phone: 507-373-2384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR 145301-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: