MRS. MEGHAN VICTORIA KLINCK (NPI# 1275594103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275594103 |
Entity Type | Individual |
Full Name | MRS. MEGHAN VICTORIA KLINCK |
Credential | PA C |
Practice Address |
13255 W Bluemound Rd Suite 103 Brookfield WI 53005-6245 |
Practice Telephone | 2627862875 |
Practice Fax Number | 2627862096 |
Mailing Telephone | 2627862875 |
Mailing Fax Number | 2627862096 |
Enumeration Date | 2006-03-30 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1519 | WI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 41964700 | 05 |
Street Address |
13255 W BLUEMOUND RD SUITE 103 |
City | BROOKFIELD |
State | WI |
Zip Code | 53005-6245 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386616324 | Kellye Joy Knueppel | Optometrist | 13255 W Bluemound Rd, Suite 200, Brookfield, WI 53005-6245 | 2006-02-03 |
1508209438 | Hometown Hospice & Homecare Inc | Home Health | 13255 W Bluemound Rd, Suite 103, Brookfield, WI 53005-6245 | 2013-04-10 |
1396035960 | Brandon Arthur Begotka | Optometrist | 13255 W Bluemound Rd, Suite 200, Brookfield, WI 53005-6245 | 2011-04-15 |
1871728253 | Carolyn J Klotz | Nurse Practitioner | 13255 W Bluemound Rd, Suite 103, Brookfield, WI 53005-6245 | 2009-05-28 |
1396903233 | The Vision Therapy Center, Inc. | Optometrist | 13255 W Bluemound Rd, Suite 200, Brookfield, WI 53005-6245 | 2008-05-28 |
1447477245 | Bluemound Orthopaedic Group, Ltd | Specialist | 13255 W Bluemound Rd, Suite 103, Brookfield, WI 53005-6245 | 2007-04-20 |
1609839497 | Eye Prosthetics of Wisconsin | Technician/Technologist | 13255 W Bluemound Rd, 101, Brookfield, WI 53005-6245 | 2006-04-11 |
1538120837 | John Richard Phillips | Orthopaedic Surgery | 13255 W Bluemound Rd, Suite 103, Brookfield, WI 53005-6245 | 2006-03-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
Find all providers in zip 53005 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629544564 | Kurt Leonard Dubay | Physician Assistant | 60 Old New Milford Rd Ste 3e, Brookfield, CT 06804-2414 | 2018-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821612045 | Cassidy Renee Thomas | Physician Assistant | 1111 Delafield St Ste 209, Waukesha, WI 53188-3403 | 2020-06-03 |
1982056768 | Luke Harbers | Physician Assistant | 6226 Bankers Rd Ste 11, Mount Pleasant, WI 53403-9799 | 2016-07-06 |
1093085664 | Abraham David Pacheco | Physician Assistant | 3246 S 35th St, Milwaukee, WI 53215-4156 | 2012-01-12 |
1346577954 | Darren Rosser | Physician Assistant | 2931 S 108th St, West Allis, WI 53227-3519 | 2009-11-03 |
1033359401 | Matthew S. Bay | Physician Assistant | 1818 N. Meade St Suite 240 West, Fox Valley Surgical Associates, Appleton, WI 54911-3496 | 2009-02-25 |
1265657068 | Surgical and Rehab Services Inc | Physician Assistant | E4051 Steven Way, Spring Green, WI 53588-9271 | 2007-04-16 |
1992844385 | Jill Ann Schumacher | Physician Assistant | 2265 90th St, Eau Claire, WI 54703-0181 | 2007-02-05 |
1609915073 | Brian Felix Robinson | Physician Assistant | S725 Turner Valley Rd, Mondovi, WI 54755-8331 | 2007-02-05 |
1124176383 | William Henry Price | Physician Assistant | 4819 5th Ave, Unit 2, Kenosha, WI 53140-2924 | 2007-01-06 |
1619032919 | Michael R Depew | Physician Assistant | 1650 S. 41st St., Lakeshore Orthopedics, Manitowoc, WI 54220 | 2006-12-27 |
Find all providers with the same taxonomy |
City | BROOKFIELD |
Zip Code | 53005 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.