Provider Demographics
NPI:1851364384
Name:MEIER, KATHLEEN D (NP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:D
Last Name:MEIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 S. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526
Mailing Address - Country:US
Mailing Address - Phone:574-537-8326
Mailing Address - Fax:574-537-1034
Practice Address - Street 1:2006 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-3819
Practice Address - Country:US
Practice Address - Phone:574-537-8326
Practice Address - Fax:574-537-1034
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001666A363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200276140Medicaid
Q32058Medicare UPIN
184520LLMedicare ID - Type Unspecified