Provider Demographics
NPI:1790163103
Name:MYERS, FLOSSIE MARIE (LICENSE TO OPERATE H)
Entity Type:Individual
Prefix:MRS
First Name:FLOSSIE
Middle Name:MARIE
Last Name:MYERS
Suffix:
Gender:F
Credentials:LICENSE TO OPERATE H
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 CHANNING DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201
Mailing Address - Country:US
Mailing Address - Phone:717-446-0539
Mailing Address - Fax:717-446-0648
Practice Address - Street 1:437 CHANNING DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-446-0539
Practice Address - Fax:717-446-0648
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27043601163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health