Provider Demographics
NPI:1649654187
Name:MEADER, DANIELLE (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MEADER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12 HIGH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7690
Mailing Address - Country:US
Mailing Address - Phone:207-795-5710
Mailing Address - Fax:207-795-2559
Practice Address - Street 1:12 HIGH ST STE 401
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7690
Practice Address - Country:US
Practice Address - Phone:207-795-5710
Practice Address - Fax:207-795-2559
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPA1547363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant