Provider Demographics
NPI:1073051678
Name:MEYER, DENISE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LYNN
Last Name:MEYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 SAND POINTE TRL
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-6663
Mailing Address - Country:US
Mailing Address - Phone:239-595-0485
Mailing Address - Fax:
Practice Address - Street 1:822 SAND POINTE TRL
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-6663
Practice Address - Country:US
Practice Address - Phone:239-595-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5300260401835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology