Provider Demographics
NPI:1528339082
Name:MEANOR, PANA MARTIN (NP)
Entity type:Individual
Prefix:MRS
First Name:PANA
Middle Name:MARTIN
Last Name:MEANOR
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2424 ERWIN RD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3824
Mailing Address - Country:US
Mailing Address - Phone:919-970-7643
Mailing Address - Fax:919-681-6065
Practice Address - Street 1:5524 HOSPITAL N
Practice Address - Street 2:BOX 100500, MEDICAL CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-970-7643
Practice Address - Fax:919-681-2605
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-15
Last Update Date:2012-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC930072363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care