Individual
MRS. COURTNEY NICOLE MEINDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4545 ALAMEDA BLVD NE STE G, ALBUQUERQUE, NM 87113-1591
(505) 896-2900
(505) 938-4198
Mailing address
4545 ALAMEDA BLVD NE STE G, ALBUQUERQUE, NM 87113-1591
(505) 896-2900
(505) 938-4198
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0004740
CO
363A00000X
Physician Assistant
Primary
PA2021-0032
NM
363AM0700X
Medical Physician Assistant
PA00792
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
762
STATE PA LICENSE
AL
01
—
PA.0004740
LICENSE
CO
01
—
PA00792
STATE LICENSE
RI
Enumeration date
05/26/2011
Last updated
05/19/2021
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