Provider Demographics
NPI:1235250333
Name:MEYER, JANICE ANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10012 KENNERLY RD
Mailing Address - Street 2:STE 102
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2197
Mailing Address - Country:US
Mailing Address - Phone:314-525-4225
Mailing Address - Fax:314-525-4229
Practice Address - Street 1:10012 KENNERLY RD
Practice Address - Street 2:STE 102
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2197
Practice Address - Country:US
Practice Address - Phone:314-525-4225
Practice Address - Fax:314-525-4229
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO156820002OtherMEDICARE PTAN #