Provider Demographics
NPI:1659743318
Name:CHRISTIAN, MEGHAN LYNN (AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:LYNN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:LYNN
Other - Last Name:DOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGPCNP-BC
Mailing Address - Street 1:3200 PLEASANT VALLEY RD
Mailing Address - Street 2:PULMONARY DISEASES
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-9274
Mailing Address - Country:US
Mailing Address - Phone:262-836-7300
Mailing Address - Fax:262-836-7301
Practice Address - Street 1:3200 PLEASANT VALLEY RD
Practice Address - Street 2:PULMONARY DISEASES
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-9274
Practice Address - Country:US
Practice Address - Phone:262-689-0973
Practice Address - Fax:262-836-7301
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171395363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1659743318Medicaid