Healthcare Provider Details

I. General information

NPI: 1275832230
Provider Name (Legal Business Name): ALISON J MEYER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 DEERWOOD AVE NW WADENA MEDICAL CENTER
WADENA MN
56482-1296
US

IV. Provider business mailing address

415 JEFFERSON ST NORTH TRI-COUNTY HOSPITAL
WADENA MN
56482-1296
US

V. Phone/Fax

Practice location:
  • Phone: 218-631-1360
  • Fax: 218-631-7507
Mailing address:
  • Phone: 218-631-3510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR174423-9
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR174423-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: