Provider Demographics
NPI:1326111394
Name:MYERS, CHARLOTTE SCHIESTEL (NP)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:SCHIESTEL
Last Name:MYERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:SCHIESTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:541 SUNSET LN STE 103
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3903
Practice Address - Country:US
Practice Address - Phone:540-829-4440
Practice Address - Fax:540-825-4026
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1824363LA2200X
VA0024180942363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ637058Medicaid
AZZ147740Medicare PIN