Provider Demographics
NPI:1386211597
Name:DEASY, MEAGHANN E (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEAGHANN
Middle Name:E
Last Name:DEASY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N CHARLES ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-5556
Mailing Address - Country:US
Mailing Address - Phone:262-719-1106
Mailing Address - Fax:
Practice Address - Street 1:1710 S 7TH ST STE 300
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3538
Practice Address - Country:US
Practice Address - Phone:414-645-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIF03210426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily