Provider Demographics
NPI:1093002461
Name:MEIER, HALEY E (PA)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:E
Last Name:MEIER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14155 N 83RD AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-5640
Mailing Address - Country:US
Mailing Address - Phone:623-215-0911
Mailing Address - Fax:623-215-0912
Practice Address - Street 1:14155 N 83RD AVE STE 110
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5640
Practice Address - Country:US
Practice Address - Phone:623-215-0911
Practice Address - Fax:623-215-0912
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2793363A00000X
AZ5405363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1093002461Medicaid
WI1093002461Medicaid
WI68086 1219Medicare PIN
WI73601 2415Medicare PIN