Provider Demographics
NPI:1336394105
Name:MYERS, CHERYL L (RN, ANP, BC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:MYERS
Suffix:
Gender:F
Credentials:RN, ANP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20805 W 151ST ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7249
Mailing Address - Country:US
Mailing Address - Phone:913-780-4900
Mailing Address - Fax:913-780-0949
Practice Address - Street 1:20805 W 151ST ST STE 400
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7249
Practice Address - Country:US
Practice Address - Phone:913-780-4900
Practice Address - Fax:913-780-0949
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO128654364SA2200X
KS53-4633363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00836074OtherRAILROAD MEDICARE
KS200594300DMedicaid
MO1336394105Medicaid
KS200594300CMedicaid
MO200594300BMedicaid
KS200594300CMedicaid
MOMA2492016Medicare PIN
KS200594300DMedicaid
KSKA2004035Medicare PIN