Provider Demographics
NPI:1649473125
Name:MEERS, VELVET ANN
Entity type:Individual
Prefix:
First Name:VELVET
Middle Name:ANN
Last Name:MEERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VELVET
Other - Middle Name:ANN
Other - Last Name:EYNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12320 COUNTY ROAD 4027
Mailing Address - Street 2:
Mailing Address - City:TEBBETTS
Mailing Address - State:MO
Mailing Address - Zip Code:65080-1437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1024 ADAMS ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-3408
Practice Address - Country:US
Practice Address - Phone:573-635-1320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115168314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility