Provider Demographics
NPI:1932272911
Name:MEYERS, NANETTE RAE (MSPT)
Entity Type:Individual
Prefix:
First Name:NANETTE
Middle Name:RAE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:NANETTE
Other - Middle Name:RAE
Other - Last Name:SCHLEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:4411 MONTANO RD NW
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3235
Mailing Address - Country:US
Mailing Address - Phone:505-898-8300
Mailing Address - Fax:505-898-8313
Practice Address - Street 1:4411 MONTANO RD NW
Practice Address - Street 2:SUITE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3235
Practice Address - Country:US
Practice Address - Phone:505-898-8300
Practice Address - Fax:505-898-8313
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist