Basic Information
| Provider Information | |||||||||
| NPI: | 1073985388 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEEKER | ||||||||
| FirstName: | DANIELLE | ||||||||
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| Credential: | MPAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12409 W INDIAN SCHOOL RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | AVONDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853929502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239359920 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12409 W INDIAN SCHOOL RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | AVONDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853929502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239359920 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2015 | ||||||||
| LastUpdateDate: | 06/22/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 6122 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.