Provider Demographics
NPI:1992918783
Name:MEINERT, JEANNE ELLEN (PT)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:ELLEN
Last Name:MEINERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12448 CHOKECHERRY CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3688
Mailing Address - Country:US
Mailing Address - Phone:907-344-8911
Mailing Address - Fax:
Practice Address - Street 1:3330 ARCTIC BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4580
Practice Address - Country:US
Practice Address - Phone:907-550-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK271OtherPHYSICAL THERAPY LICENSE