Provider Demographics
NPI:1952672743
Name:MEILLER, DENNIS L (LPN)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:L
Last Name:MEILLER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S BRITTINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1417
Mailing Address - Country:US
Mailing Address - Phone:608-255-6187
Mailing Address - Fax:
Practice Address - Street 1:101 S BRITTINGHAM PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1417
Practice Address - Country:US
Practice Address - Phone:608-255-6187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31586-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse