Provider Demographics
NPI:1942251657
Name:MEINDERS, PAMELA J (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:MEINDERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:J
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2531 S GILBERT RD
Mailing Address - Street 2:STE 111
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-5874
Mailing Address - Country:US
Mailing Address - Phone:480-306-5151
Mailing Address - Fax:480-306-4648
Practice Address - Street 1:2531 S GILBERT RD
Practice Address - Street 2:STE 111
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-5874
Practice Address - Country:US
Practice Address - Phone:480-306-5151
Practice Address - Fax:480-306-4648
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ618598Medicaid
AZP00190720OtherRAILROAD
AZP49148Medicare UPIN
AZ618598001Medicaid