Provider Demographics
NPI:1770754376
Name:MEISSNER, ANN-MARIE (RN)
Entity type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:
Last Name:MEISSNER
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 1:1014 WELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-2709
Mailing Address - Country:US
Mailing Address - Phone:262-367-9051
Mailing Address - Fax:
Practice Address - Street 1:1014 WELLINGTON WAY
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2709
Practice Address - Country:US
Practice Address - Phone:262-367-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-22
Last Update Date:2008-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI97636-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35036700Medicaid