Provider Demographics
NPI:1043613128
Name:PADEN, MICHELE C (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:C
Last Name:PADEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2808
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-2808
Mailing Address - Country:US
Mailing Address - Phone:480-882-5254
Mailing Address - Fax:480-882-4449
Practice Address - Street 1:3604 N WELLS FARGO AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5629
Practice Address - Country:US
Practice Address - Phone:480-882-5254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5832363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant