Provider Demographics
NPI:1821483983
Name:MEYERS, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MEYERS
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 1:141 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-5320
Mailing Address - Country:US
Mailing Address - Phone:315-729-1156
Mailing Address - Fax:
Practice Address - Street 1:141 LAKE AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-5320
Practice Address - Country:US
Practice Address - Phone:315-729-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-05
Last Update Date:2015-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY512040-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse