1669674966 NPI number — MRS. NIAMH I VAN MEINES MS, ANP-BC

Table of content: MRS. NIAMH I VAN MEINES MS, ANP-BC (NPI 1669674966)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669674966 NPI number — MRS. NIAMH I VAN MEINES MS, ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAN MEINES
Provider First Name:
NIAMH
Provider Middle Name:
I
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, ANP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669674966
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
117 BROOKLINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORAGA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94556-1016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-592-0970
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2440 23RD ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95501-3203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-442-5683
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  95110811 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 95005738 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com