Provider Demographics
NPI:1265612105
Name:MEYERS, DONNA MARIE (APN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:ALBERT-MEYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:6000 BOND AVE
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62207-2328
Mailing Address - Country:US
Mailing Address - Phone:618-332-2740
Mailing Address - Fax:618-332-8755
Practice Address - Street 1:6000 BOND AVE
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:IL
Practice Address - Zip Code:62207-2328
Practice Address - Country:US
Practice Address - Phone:618-332-2740
Practice Address - Fax:618-332-8755
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041352460163W00000X
IL209006372364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal
No163W00000XNursing Service ProvidersRegistered Nurse