MEDICARE: NICOLE ALISE MEYER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA223575	OR

General Provider Information

NPI Number	:	1124800313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ALISE MEYER PA-C

Provider Business Mailing Address
First Line	:	2821 DAGGETT AVE STE 200
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1130
Country	:	US
Telephone Number	:	415-274-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2865 DAGGETT AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1106
Country	:	US
Telephone Number	:	541-591-1164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	12/15/2025

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Directions to “ NICOLE ALISE MEYER PA-C” Practice Location

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