Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MINDY BACCAM SOUTHAMMAVONG, PA-C
ActiveMINDY BACCAM SOUTHAMMAVONG, PA-C is a Medical Physician Assistant healthcare provider located in PELLA, Iowa. NPI 1528434859 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · PELLA, IA
Registration Details
- NPI Number
- 1528434859
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 20, 2015 (10.802280038321 yrs)
- Last Updated
- May 1, 2017
- License
-
078982 (IA)
Practice Information
- Address
-
405 MONROE STPELLA, IA, 502191189Browse IA providers · Browse ZIP 50219
- Phone
- 6416212200
- Fax
- 6416212335
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in PELLA, IA
| Name | Credential | NPI |
|---|---|---|
| KAREN K EMMERT | PHYSICIAN ASSISTANT | 1720058423 |
| JENNIFER L WADLE | PA-C | 1558339267 |
| HEATHER MARIE OPSETH | PHYSICIAN ASSISTANT | 1588928428 |
| MS. JORDAN LEA GREINER | PA-C | 1962885707 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.