Provider Demographics
NPI:1396003216
Name:MYERS, LORI LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 WAYNE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-8651
Mailing Address - Country:US
Mailing Address - Phone:740-453-2696
Mailing Address - Fax:
Practice Address - Street 1:3105 WAYNE RIDGE RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-8651
Practice Address - Country:US
Practice Address - Phone:740-453-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-28
Last Update Date:2012-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN063935164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse