Provider Demographics
NPI:1801274816
Name:MYERS, AMBER LYNN (LPN)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:LYNN
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16217 GIPE ROAD
Mailing Address - Street 2:
Mailing Address - City:NEY
Mailing Address - State:OH
Mailing Address - Zip Code:43549
Mailing Address - Country:US
Mailing Address - Phone:419-438-2094
Mailing Address - Fax:
Practice Address - Street 1:16217 GIPE RD
Practice Address - Street 2:
Practice Address - City:NEY
Practice Address - State:OH
Practice Address - Zip Code:43549-9727
Practice Address - Country:US
Practice Address - Phone:419-438-2094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH123159164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse