Provider Demographics
NPI:1730795659
Name:PAULEY, PAIGE J (PA-C)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:J
Last Name:PAULEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:J
Other - Last Name:CORNWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:717 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:NE
Mailing Address - Zip Code:68920-2132
Mailing Address - Country:US
Mailing Address - Phone:308-928-2151
Mailing Address - Fax:
Practice Address - Street 1:717 BROWN ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:NE
Practice Address - Zip Code:68920-2132
Practice Address - Country:US
Practice Address - Phone:308-928-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2537363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant