Basic Information
Provider Information
NPI: 1275832230
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYER
FirstName: ALISON
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 415 JEFFERSON ST NORTH
Address2: TRI-COUNTY HOSPITAL
City: WADENA
State: MN
PostalCode: 564821296
CountryCode: US
TelephoneNumber: 2186313510
FaxNumber:  
Practice Location
Address1: 4 DEERWOOD AVE NW
Address2: WADENA MEDICAL CENTER
City: WADENA
State: MN
PostalCode: 564821296
CountryCode: US
TelephoneNumber: 2186311360
FaxNumber: 2186317507
Other Information
ProviderEnumerationDate: 03/16/2011
LastUpdateDate: 09/17/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XR174423-9MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XR174423-9MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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