Provider Demographics
NPI:1508024175
Name:HADA, AIMEE LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:LYNN
Last Name:HADA
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 1:4126 E JASPER DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-8461
Mailing Address - Country:US
Mailing Address - Phone:480-246-0753
Mailing Address - Fax:
Practice Address - Street 1:2919 S ELLSWORTH RD
Practice Address - Street 2:STE. 124
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-2164
Practice Address - Country:US
Practice Address - Phone:480-361-3636
Practice Address - Fax:480-361-2525
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3731363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical