Provider Demographics
NPI:1891783601
Name:MEYER, WENDY FAYE (DC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:FAYE
Last Name:MEYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 RIVERSIDE BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2853
Mailing Address - Country:US
Mailing Address - Phone:402-844-4878
Mailing Address - Fax:402-371-0551
Practice Address - Street 1:904 RIVERSIDE BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-2853
Practice Address - Country:US
Practice Address - Phone:402-844-4878
Practice Address - Fax:402-371-0551
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE16161745400Medicaid
NE16161745400Medicaid
NENA1855001Medicare PIN
NEU91439Medicare UPIN