Provider Demographics
NPI:1518202340
Name:MYERS, CODY (PA-C)
Entity Type:Individual
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First Name:CODY
Middle Name:
Last Name:MYERS
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Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1649 LUCERNE ST
Mailing Address - Street 2:SUITE A & B
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4369
Mailing Address - Country:US
Mailing Address - Phone:775-782-1603
Mailing Address - Fax:775-782-3417
Practice Address - Street 1:1649 LUCERNE ST
Practice Address - Street 2:SUITE A & B
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4369
Practice Address - Country:US
Practice Address - Phone:775-782-1603
Practice Address - Fax:775-782-3417
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant