Provider Demographics
NPI:1760462626
Name:MEYER, MARGARET MARY (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:MEYER
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6850
Mailing Address - Fax:414-805-6851
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6850
Practice Address - Fax:414-805-6851
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2014-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI47229163W00000X
WI1711033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1760462626Medicaid
WI022T73601Medicare PIN