Healthcare Provider Details

I. General information

NPI: 1689370819
Provider Name (Legal Business Name): DIANNE MEECE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

IV. Provider business mailing address

662 HAWTHORN DR
SUN PRAIRIE WI
53590-8002
US

V. Phone/Fax

Practice location:
  • Phone: 608-280-7002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number157783
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: