Provider Demographics
NPI:1841912441
Name:MEYER, JEANNETTE (RN, CNS)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 16TH ST RM 209
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1804
Mailing Address - Country:US
Mailing Address - Phone:310-210-9270
Mailing Address - Fax:
Practice Address - Street 1:1328 16TH ST RM 209
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1804
Practice Address - Country:US
Practice Address - Phone:310-210-9270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA701558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty