Provider Demographics
NPI:1003084294
Name:MEETER, DENA KAE (APRN)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:KAE
Last Name:MEETER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:
Other - Last Name:CASSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7455 W WASHINGTON AVE
Mailing Address - Street 2:#160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4337
Mailing Address - Country:US
Mailing Address - Phone:702-878-0393
Mailing Address - Fax:702-940-5601
Practice Address - Street 1:7455 W WASHINGTON AVE
Practice Address - Street 2:#160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4337
Practice Address - Country:US
Practice Address - Phone:702-878-0393
Practice Address - Fax:702-940-5601
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP17506363L00000X
HIAPRN1607363LP0200X
NVAPRN001924363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
13570942OtherCAQH
HIHI04231Medicare PIN