Provider Demographics
NPI:1720342744
Name:MYERS, ARNEATRICE DARNELL
Entity Type:Individual
Prefix:
First Name:ARNEATRICE
Middle Name:DARNELL
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3414
Mailing Address - Country:US
Mailing Address - Phone:314-771-5800
Mailing Address - Fax:
Practice Address - Street 1:3900 S GRAND BLVD
Practice Address - Street 2:3900 SOUTH GRAND
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3414
Practice Address - Country:US
Practice Address - Phone:314-771-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010015131363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health