Provider Demographics
NPI:1770586950
Name:MUETING, PAUL R (PA)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:MUETING
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2168
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2168
Mailing Address - Country:US
Mailing Address - Phone:308-865-2512
Mailing Address - Fax:308-865-2506
Practice Address - Street 1:3500 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2944
Practice Address - Country:US
Practice Address - Phone:308-865-2512
Practice Address - Fax:308-865-2506
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE994363A00000X
KS15-01008363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS426846OtherBCBS
NEP00178411OtherRAILROAD MEDICARE
234493OtherMIDLANDS CHOICE
KS200316500Medicaid
NE37464OtherBCBS
KSP00977417OtherRAILROAD MEDICARE
NE561829082Medicaid
P46280Medicare UPIN
NE561829082Medicaid
NE37464OtherBCBS