Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 29570 | WI |
NPI | 1477658029 |
---|---|
Provider Name | Dr. Kathleen J Meyer |
First Address | Appleton, WI 54915-7802 |
Second Address | Appleton, WI 54915-7802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
203932743 | TAX ID (01) | WI |
E81929 | (02) | WI |