Healthcare Provider Details

I. General information

NPI: 1902136047
Provider Name (Legal Business Name): KATHERINE MEINE CNM, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S MAIN ST STE 105
OSHKOSH WI
54902-6074
US

IV. Provider business mailing address

600 S MAIN ST STE 105
OSHKOSH WI
54902-6074
US

V. Phone/Fax

Practice location:
  • Phone: 920-981-8610
  • Fax: 920-567-3971
Mailing address:
  • Phone: 920-981-8610
  • Fax: 920-567-3971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number148839-32
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number170811
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4003
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: