Provider Demographics
NPI:1437191293
Name:CARLI, ANN MEIER (OD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MEIER
Last Name:CARLI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3237 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-1643
Mailing Address - Country:US
Mailing Address - Phone:920-336-2020
Mailing Address - Fax:920-336-2709
Practice Address - Street 1:3237 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1643
Practice Address - Country:US
Practice Address - Phone:920-336-2020
Practice Address - Fax:920-336-2709
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1957152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00049055OtherRAILROAD MEDICARE
P00049055OtherRAILROAD MEDICARE
WI000017252Medicare PIN