Individual
JACQUELINE A MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
115 WYOMING ST, LANDER, WY 82520-3919
(307) 332-2185
(307) 332-7799
Mailing address
115 WYOMING ST, LANDER, WY 82520-3919
(307) 332-2185
(307) 332-7799
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2012002532
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154940001
MEDICARE PTAN
MO
Enumeration date
05/03/2012
Last updated
02/24/2021
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