Provider Demographics
NPI:1184511776
Name:MYERS, BRENDA J (LPN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:J
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 POPLAR RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5253
Mailing Address - Country:US
Mailing Address - Phone:732-289-5520
Mailing Address - Fax:732-289-5520
Practice Address - Street 1:44 JONES ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-3021
Practice Address - Country:US
Practice Address - Phone:973-878-9020
Practice Address - Fax:888-210-4703
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06937900164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse