Provider Demographics
NPI:1043889553
Name:MEINERS, CAYLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:CAYLEY
Middle Name:
Last Name:MEINERS
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 1:3106 OUTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-5270
Mailing Address - Country:US
Mailing Address - Phone:618-997-4332
Mailing Address - Fax:618-997-6205
Practice Address - Street 1:3106 OUTER DR STE 200
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5270
Practice Address - Country:US
Practice Address - Phone:618-997-4332
Practice Address - Fax:618-997-6205
Is Sole Proprietor?:No
Enumeration Date:2021-06-19
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085008290363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant