Provider Demographics
NPI:1417178732
Name:MEYERS, SUZANNE MICHELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1694 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-1900
Mailing Address - Country:US
Mailing Address - Phone:317-736-6442
Mailing Address - Fax:
Practice Address - Street 1:3540 MIDFIELD SERVICE RD
Practice Address - Street 2:SAFETY ORIENTATION TRAILER
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-3619
Practice Address - Country:US
Practice Address - Phone:317-487-4175
Practice Address - Fax:317-487-7282
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002171363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health