Provider Demographics
NPI:1790539617
Name:MYERS, LYNN
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:AZ
Mailing Address - Zip Code:85927-0164
Mailing Address - Country:US
Mailing Address - Phone:602-702-0676
Mailing Address - Fax:
Practice Address - Street 1:15 COUNTY RD N1060
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:AZ
Practice Address - Zip Code:85927
Practice Address - Country:US
Practice Address - Phone:602-702-0676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider