Provider Demographics
NPI:1770706533
Name:EVANS BELKNAP, MEAGHAN (CNM, RN)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:EVANS BELKNAP
Suffix:
Gender:F
Credentials:CNM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW GLARUS
Mailing Address - State:WI
Mailing Address - Zip Code:53574-9621
Mailing Address - Country:US
Mailing Address - Phone:608-527-5422
Mailing Address - Fax:
Practice Address - Street 1:302 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-5904
Practice Address - Country:US
Practice Address - Phone:414-271-8045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11979367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife