Provider Demographics
NPI:1669674966
Name:VAN MEINES, NIAMH I (MS, ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:NIAMH
Middle Name:I
Last Name:VAN MEINES
Suffix:
Gender:F
Credentials:MS, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BROOKLINE ST
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1016
Mailing Address - Country:US
Mailing Address - Phone:925-592-0970
Mailing Address - Fax:
Practice Address - Street 1:2440 23RD ST STE B
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3203
Practice Address - Country:US
Practice Address - Phone:707-442-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95110811163W00000X
CA95005738363LA2200X
NY370032-1363L00000X
NY303974-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner