Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 10771-33 | WI |
N | 363LA2100X | Nurse Practitioner - Acute Care | 209.022918 | IL |
N | 363LA2200X | Nurse Practitioner - Adult Health | 10771-33 | WI |
N | 363LA2200X | Nurse Practitioner - Adult Health | 209.022918 | IL |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 10771-33 | WI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209.022918 | IL |
NPI | 1538754395 |
---|---|
Provider Name | Kirk D Meyer |
First Address | Harvard, IL 60033-8100 |
Second Address | Menomonee Falls, WI 53051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2021 |
Last Update Date | 03/03/2021 |