Provider Demographics
NPI:1376945402
Name:DRYER, CYNTHIA MYERS (RN, NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MYERS
Last Name:DRYER
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:SUE
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:560 W. MITCHELL ST.
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49970
Mailing Address - Country:US
Mailing Address - Phone:231-487-3590
Mailing Address - Fax:
Practice Address - Street 1:560 W. MITCHELL ST.
Practice Address - Street 2:SUITE 170
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49970
Practice Address - Country:US
Practice Address - Phone:231-487-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704246485363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner