Provider Demographics
NPI:1194398487
Name:MYERS, WENDY L
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-1015
Mailing Address - Country:US
Mailing Address - Phone:440-796-4486
Mailing Address - Fax:
Practice Address - Street 1:1541 GROVE AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-1015
Practice Address - Country:US
Practice Address - Phone:440-796-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker