Provider Demographics
NPI:1518416957
Name:MEYERS, ANNE MARIE
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE MARIE
Other - Middle Name:
Other - Last Name:WENTZELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:833-213-6428
Practice Address - Street 1:330 N BEST AVE
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-1205
Practice Address - Country:US
Practice Address - Phone:610-628-8922
Practice Address - Fax:833-816-5610
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058515363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical