Provider Demographics
NPI:1689000440
Name:MEYER, SHONNA LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHONNA
Middle Name:LYNN
Last Name:MEYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 GLEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6100
Mailing Address - Country:US
Mailing Address - Phone:803-931-6746
Mailing Address - Fax:
Practice Address - Street 1:200 N HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-2300
Practice Address - Country:US
Practice Address - Phone:864-834-7269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist