Provider Demographics
NPI:1801310461
Name:MYERS, CHRISTINE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 OLD EKRON RD
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-8361
Mailing Address - Country:US
Mailing Address - Phone:502-684-8446
Mailing Address - Fax:270-226-7802
Practice Address - Street 1:1404 OLD EKRON RD
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-8361
Practice Address - Country:US
Practice Address - Phone:502-684-8446
Practice Address - Fax:270-226-7802
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011630363LF0000X
IN71011578A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3011630OtherKENTUCKY APRN LICENSE