Individual
STACY MEITLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150
(734) 793-6140
(734) 402-0254
Mailing address
2205 JOLLY RD STE B, OKEMOS, MI 48864-3983
(517) 347-4085
(517) 347-4170
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704235508
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205297876
—
MI
Enumeration date
03/10/2016
Last updated
06/15/2018
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