Provider Demographics
NPI:1306388988
Name:MEYERS, JEVGENIJA (RD)
Entity Type:Individual
Prefix:
First Name:JEVGENIJA
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 N CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4714
Mailing Address - Country:US
Mailing Address - Phone:248-982-6574
Mailing Address - Fax:
Practice Address - Street 1:2025 TRAVERWOOD DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2197
Practice Address - Country:US
Practice Address - Phone:734-998-2163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1036361133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered