Provider Demographics
NPI:1215992755
Name:MEIGHAN, LAURIE J (APNP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:J
Last Name:MEIGHAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S MADISON ST
Mailing Address - Street 2:STE 1
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813-2045
Mailing Address - Country:US
Mailing Address - Phone:608-723-2131
Mailing Address - Fax:608-723-2707
Practice Address - Street 1:500 S MADISON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-2045
Practice Address - Country:US
Practice Address - Phone:608-723-2131
Practice Address - Fax:608-723-2707
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2082363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1044567OtherPHYSICIANS PLUS
MN370S2MEOtherBLUE CROSS BLUE SHIELD
WI43976300Medicaid
WI60080OtherDEAN HEALTH INSURANCE
WI500025547Medicare PIN
WI60080OtherDEAN HEALTH INSURANCE
MN370S2MEOtherBLUE CROSS BLUE SHIELD