Healthcare Provider Details

I. General information

NPI: 1215992755
Provider Name (Legal Business Name): LAURIE J MEIGHAN APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S MADISON ST SUITE 1
LANCASTER WI
53813-2045
US

IV. Provider business mailing address

500 S MADISON ST STE 1
LANCASTER WI
53813-2045
US

V. Phone/Fax

Practice location:
  • Phone: 608-723-2131
  • Fax: 608-723-2707
Mailing address:
  • Phone: 608-723-2131
  • Fax: 608-723-2707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2082
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: