Provider Demographics
NPI:1407347537
Name:MEYER, ADRIANA MELISSA (NP)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:MELISSA
Last Name:MEYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4852 BOBBY JEFFERY DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7075
Mailing Address - Country:US
Mailing Address - Phone:423-802-6820
Mailing Address - Fax:
Practice Address - Street 1:320 BEARD CREEK RD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632
Practice Address - Country:US
Practice Address - Phone:970-945-2840
Practice Address - Fax:970-945-1055
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0001046-C-NP363L00000X
TNF02180544363L00000X
CO0001046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner