Provider Demographics
NPI:1609926393
Name:MEYER, EILEEN MARIE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:MARIE
Last Name:MEYER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 N EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5242
Mailing Address - Country:US
Mailing Address - Phone:706-627-2561
Mailing Address - Fax:
Practice Address - Street 1:1781 METROMEDICAL DR
Practice Address - Street 2:FAYETTEVILLE AMBULATORY SURGERY CENTER
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304
Practice Address - Country:US
Practice Address - Phone:910-323-1647
Practice Address - Fax:866-998-0626
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1379022122367500000X
NC250370367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered