Provider Demographics
NPI:1760905004
Name:MYERS, CARRI J (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CARRI
Middle Name:J
Last Name:MYERS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 E MAIN ST STE 24
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-2300
Mailing Address - Country:US
Mailing Address - Phone:601-781-8677
Mailing Address - Fax:601-207-7720
Practice Address - Street 1:3531 LAKELAND DR STE 1060
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8016
Practice Address - Country:US
Practice Address - Phone:601-420-5810
Practice Address - Fax:601-420-5811
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS902140363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health