Provider Demographics
NPI:1346800026
Name:MEYERS, MARY M (CRNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:MEYERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GRANT AVE # G8
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3858
Mailing Address - Country:US
Mailing Address - Phone:412-508-8913
Mailing Address - Fax:
Practice Address - Street 1:6 GRANT AVE # G8
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:PA
Practice Address - Zip Code:15202-3858
Practice Address - Country:US
Practice Address - Phone:412-508-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-16
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020308363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health