Provider Demographics
NPI:1619003308
Name:VANMEETEREN, PAMILA GAIL (CNP)
Entity Type:Individual
Prefix:MS
First Name:PAMILA
Middle Name:GAIL
Last Name:VANMEETEREN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 GAVINS POINT RD
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-6206
Mailing Address - Country:US
Mailing Address - Phone:605-665-7981
Mailing Address - Fax:
Practice Address - Street 1:1028 WALNUT ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-2910
Practice Address - Country:US
Practice Address - Phone:605-665-4606
Practice Address - Fax:605-665-4673
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS48355Medicare UPIN