Provider Demographics
NPI:1609541762
Name:MEINEN, AMBER R (RN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:MEINEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S86W19002 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-8190
Mailing Address - Country:US
Mailing Address - Phone:414-202-0993
Mailing Address - Fax:
Practice Address - Street 1:S86W19002 WOODS RD
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-8190
Practice Address - Country:US
Practice Address - Phone:414-202-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI162032-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse