1770355943 NPI number — ISABELLE MEEHL

Table of content: ISABELLE MEEHL (NPI 1770355943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770355943 NPI number — ISABELLE MEEHL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEEHL
Provider First Name:
ISABELLE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WINGERD
Provider Other First Name:
ISABELLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1770355943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10733 W LAW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH EAST
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16428-3866
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-401-2410
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ERIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16550-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-877-2938
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN672660 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN672660 . This is a "PA RN LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".