Provider Demographics
NPI:1225045354
Name:BYERS, MONICA L (APRN)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:BYERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 RIVER RD N UNIT 21311
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97307-0856
Mailing Address - Country:US
Mailing Address - Phone:702-781-0043
Mailing Address - Fax:
Practice Address - Street 1:1375 N 10TH AVE STE A
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-2099
Practice Address - Country:US
Practice Address - Phone:702-281-6552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001192363LA2200X
OR201802846NP-PP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE48648Medicare UPIN
FLK5039Medicare ID - Type UnspecifiedCORPORATE MEDICARE ID