Provider Demographics
NPI:1447228846
Name:MEYERS, RACHEL COLLEEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:COLLEEN
Last Name:MEYERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S SUNNY SLOPE RD
Mailing Address - Street 2:SUNNYSLOPE PRIMARY CARE CLINIC
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-7060
Mailing Address - Country:US
Mailing Address - Phone:414-805-9600
Mailing Address - Fax:414-805-9645
Practice Address - Street 1:1350 S SUNNY SLOPE RD
Practice Address - Street 2:SUNNYSLOPE PRIMARY CARE CLINIC
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-7060
Practice Address - Country:US
Practice Address - Phone:414-805-9600
Practice Address - Fax:414-805-9645
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45808363LF0000X
WI130395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1447228846Medicaid