Provider Demographics
NPI:1114541885
Name:MEYER, AUDREY MARY (PA)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:MARY
Last Name:MEYER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:MARY
Other - Last Name:SCHARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-5584
Practice Address - Country:US
Practice Address - Phone:507-429-4267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13485363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant