| Doctor Name: | MEGHAN J VISNICK |
| NPI Number: | 1033458534 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNMW |
| License Number: | 4704273686 |
| Business Practice Address: | 1200 Sixth St Ste 400 Traverse City, MI - 496842369 |
| Business Phone Number: | 2313920650 |
| Business Fax Number: | 2313920665 |
| Mailing Address: | 1200 Sixth St, Ste 400 TRAVERSE CITY |
| State: | MI |
| Postal Code: | 496842369 |
| Phone Number: | 2313920650 |
| Fax Number: | 2313920665 |
| NPI Enumeration Date: | 02/05/2013 |
| NPI Last Update Date: | 02/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 4704273686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |