Provider Demographics
NPI:1003847997
Name:MYERS, CARLEEN ANN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CARLEEN
Middle Name:ANN
Last Name:MYERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 6TH AVE
Mailing Address - Street 2:STE 117
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2626
Mailing Address - Country:US
Mailing Address - Phone:717-840-9885
Mailing Address - Fax:717-840-9313
Practice Address - Street 1:1600 6TH AVE
Practice Address - Street 2:STE 117
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2626
Practice Address - Country:US
Practice Address - Phone:717-840-9885
Practice Address - Fax:717-840-9313
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP000524A363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner