Provider Demographics
NPI:1326154204
Name:MEYERS, IRENE MADELINE (CNM, MSN)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:MADELINE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3408
Mailing Address - Country:US
Mailing Address - Phone:603-742-2424
Mailing Address - Fax:603-742-1763
Practice Address - Street 1:700 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3408
Practice Address - Country:US
Practice Address - Phone:603-742-2424
Practice Address - Fax:603-742-1763
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH059078-23367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHR28790Medicare UPIN