Provider Demographics
NPI:1285298950
Name:MEISCHEN, JONNA MARIE
Entity type:Individual
Prefix:
First Name:JONNA MARIE
Middle Name:
Last Name:MEISCHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JONNA MARIE
Other - Middle Name:
Other - Last Name:TOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4101 W ADAMS AVE APT 341
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-8527
Mailing Address - Country:US
Mailing Address - Phone:254-383-2893
Mailing Address - Fax:
Practice Address - Street 1:4101 W ADAMS AVE APT 341
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-8527
Practice Address - Country:US
Practice Address - Phone:254-383-2893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-27
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse