| Doctor Name: | JACQUELINE A MEYER |
| NPI Number: | 1164781696 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 2012011478 |
| Business Practice Address: | 115 Wyoming St Lander, WY - 825203919 |
| Business Phone Number: | 3073322185 |
| Business Fax Number: | 3073327799 |
| Mailing Address: | 115 Wyoming St, LANDER |
| State: | WY |
| Postal Code: | 825203919 |
| Phone Number: | 3073322185 |
| Fax Number: | 3073327799 |
| NPI Enumeration Date: | 05/03/2012 |
| NPI Last Update Date: | 04/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2012011478 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |