Provider Demographics
NPI:1760460273
Name:MEILER, SUSAN ROSE (RN)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:ROSE
Last Name:MEILER
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:PO BOX 35034
Mailing Address - Street 2:
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-0034
Mailing Address - Country:US
Mailing Address - Phone:315-771-0787
Mailing Address - Fax:907-353-4867
Practice Address - Street 1:1060 GAFFNEY RD # 7440
Practice Address - Street 2:BASSETT ARMY COMMUNITY HOSPITAL
Practice Address - City:FT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-5001
Practice Address - Country:US
Practice Address - Phone:907-353-5692
Practice Address - Fax:907-353-4867
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO161068163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health