Provider Demographics
NPI:1356082382
Name:METAYER, MENESSA AISHA
Entity Type:Individual
Prefix:
First Name:MENESSA
Middle Name:AISHA
Last Name:METAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110101 BEATY E TOWERS
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32612-0001
Mailing Address - Country:US
Mailing Address - Phone:754-304-8592
Mailing Address - Fax:
Practice Address - Street 1:1460 NW 3RD PL APT 210
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32603-3903
Practice Address - Country:US
Practice Address - Phone:352-623-1807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other