Provider Demographics
NPI:1912188517
Name:MYERS, JEANNIE C (FNP-C)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:C
Last Name:MYERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 10 BOX 1313
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09142-0014
Mailing Address - Country:US
Mailing Address - Phone:314-590-1209
Mailing Address - Fax:
Practice Address - Street 1:DR. HITZELBERGER-STRASSE
Practice Address - Street 2:
Practice Address - City:LANDSTUHL
Practice Address - State:RHINELAND-PALATINATE
Practice Address - Zip Code:66849
Practice Address - Country:DE
Practice Address - Phone:314-590-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-25
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167591363LF0000X, 363LF0000X
VA0001248668163WG0000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice