| Doctor Name: | MS. KAYLA JO MEEHAN |
| NPI Number: | 1306279104 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC |
| License Number: | 11349 |
| Business Practice Address: | 200 Elm St N Onamia, MN - 563597901 |
| Business Phone Number: | 3205323154 |
| Business Fax Number: | 3205323111 |
| Mailing Address: | 200 Elm St N, ONAMIA |
| State: | MN |
| Postal Code: | 563597901 |
| Phone Number: | 3205323154 |
| Fax Number: | 3205323111 |
| NPI Enumeration Date: | 08/15/2013 |
| NPI Last Update Date: | 09/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 11349 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |