Provider Demographics
NPI:1073672457
Name:MAYERS, JANET P (RN, CRNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:P
Last Name:MAYERS
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LODI HILL RD
Mailing Address - Street 2:
Mailing Address - City:UPPER BLACK EDDY
Mailing Address - State:PA
Mailing Address - Zip Code:18972-9586
Mailing Address - Country:US
Mailing Address - Phone:610-982-5498
Mailing Address - Fax:
Practice Address - Street 1:6 LODI HILL RD
Practice Address - Street 2:
Practice Address - City:UPPER BLACK EDDY
Practice Address - State:PA
Practice Address - Zip Code:18972-9586
Practice Address - Country:US
Practice Address - Phone:610-982-5498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP000415B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000713503OtherHIGHMARK BLUE SHIELD
PA713503Medicare ID - Type Unspecified