Provider Demographics
NPI:1740342815
Name:BYERS, ANITA L
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:L
Last Name:BYERS
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 1:2620 COUNTY ROAD 181
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:OH
Mailing Address - Zip Code:43410-9545
Mailing Address - Country:US
Mailing Address - Phone:419-355-2699
Mailing Address - Fax:419-639-0241
Practice Address - Street 1:2620 COUNTY ROAD 181
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-9545
Practice Address - Country:US
Practice Address - Phone:419-355-2699
Practice Address - Fax:419-639-0241
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2068051Medicare UPIN