Provider Demographics
NPI:1265426357
Name:MYERS, DEBRA H (CRNA)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:H
Last Name:MYERS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12061 JESSE DR
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-4011
Mailing Address - Country:US
Mailing Address - Phone:814-734-3020
Mailing Address - Fax:814-734-9089
Practice Address - Street 1:3705 5TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2584
Practice Address - Country:US
Practice Address - Phone:412-692-5260
Practice Address - Fax:412-692-8658
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN252666L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2162305Medicaid
OHP00733248OtherRAILROAD MEDICARE
OHH063043OtherOH MEDICARE PTAN
OHP00733248OtherRAILROAD MEDICARE
PA544076Medicare PIN