Provider Demographics
NPI:1962910349
Name:LOEWENSTEIN, MEREDITH GRACE (CRNP)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:GRACE
Last Name:LOEWENSTEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:GRACE
Other - Last Name:AREVALO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2217 KEYES AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2217 KEYES AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1932
Practice Address - Country:US
Practice Address - Phone:608-242-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT20180031163W00000X
MDR231732363LF0000X
WI9689363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily