Provider Demographics
NPI:1932115094
Name:MEYERS, ANNA MARY (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA MARY
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 N ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-2149
Mailing Address - Country:US
Mailing Address - Phone:662-562-0411
Mailing Address - Fax:662-560-0161
Practice Address - Street 1:104 N ROBINSON ST
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2149
Practice Address - Country:US
Practice Address - Phone:662-562-0411
Practice Address - Fax:662-560-0161
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR870891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSQ71624Medicare UPIN