Provider Demographics
NPI:1134221138
Name:MEYER, CAROL ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4407
Mailing Address - Country:US
Mailing Address - Phone:775-786-4673
Mailing Address - Fax:775-348-2889
Practice Address - Street 1:580 W 5TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503
Practice Address - Country:US
Practice Address - Phone:775-786-4673
Practice Address - Fax:775-348-2889
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 1442363LF0000X
CA11832363LF0000X
NVAPRN001191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1134221138Medicaid
HI694340Medicaid
12447544OtherCAQH