Provider Demographics
NPI:1073889606
Name:MYER, MICHELLE LORRAINE (DNP, RN, APRN, CPNP)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LORRAINE
Last Name:MYER
Suffix:
Gender:F
Credentials:DNP, RN, APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2100 BULL ST
Mailing Address - Street 2:ROOM O-412
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2104
Mailing Address - Country:US
Mailing Address - Phone:803-898-0097
Mailing Address - Fax:803-898-0897
Practice Address - Street 1:2100 BULL STREET
Practice Address - Street 2:ROOM O-412
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-898-0097
Practice Address - Fax:803-898-0897
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC1837163WC1500X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health