Provider Demographics
NPI:1255431862
Name:MEEHAN, ANNIKA DELANNA (LAC)
Entity type:Individual
Prefix:
First Name:ANNIKA
Middle Name:DELANNA
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6545 FRANCE AVE S
Mailing Address - Street 2:SUITE #373
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2131
Mailing Address - Country:US
Mailing Address - Phone:952-926-0255
Mailing Address - Fax:952-487-9137
Practice Address - Street 1:6545 FRANCE AVE S
Practice Address - Street 2:SUITE #373
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2131
Practice Address - Country:US
Practice Address - Phone:952-926-0255
Practice Address - Fax:952-487-9137
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1209171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist