Provider Demographics
NPI:1437582640
Name:HARPER, MEREDITH (NP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:THEUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3101 MILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-8142
Mailing Address - Country:US
Mailing Address - Phone:414-460-7192
Mailing Address - Fax:
Practice Address - Street 1:3101 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-8142
Practice Address - Country:US
Practice Address - Phone:414-460-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA744134163W00000X
WI158648-30163W00000X
CA22517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse