Provider Demographics
NPI:1184869224
Name:MYERS, MARIAM R (APRN-RX PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:R
Last Name:MYERS
Suffix:
Gender:F
Credentials:APRN-RX PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 KEAWE ST STE 521
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3101
Mailing Address - Country:US
Mailing Address - Phone:808-777-9460
Mailing Address - Fax:
Practice Address - Street 1:524 KEAWE ST STE 521
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3101
Practice Address - Country:US
Practice Address - Phone:808-777-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4080363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health