Provider Demographics
NPI:1790087336
Name:MEYER, JOYCE (LPN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-1212
Mailing Address - Country:US
Mailing Address - Phone:614-824-9413
Mailing Address - Fax:
Practice Address - Street 1:176 JACKSON ST
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-1212
Practice Address - Country:US
Practice Address - Phone:614-824-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.125630-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse