Provider Demographics
NPI:1982072054
Name:MYERS, CHANDLER LEANN (CNP)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:LEANN
Last Name:MYERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CHANDLER
Other - Middle Name:LEANN
Other - Last Name:JARVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 COLEGATE DR BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-9549
Mailing Address - Country:US
Mailing Address - Phone:740-568-4814
Mailing Address - Fax:740-374-3165
Practice Address - Street 1:807 FARSON ST STE 210
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1068
Practice Address - Country:US
Practice Address - Phone:740-376-5000
Practice Address - Fax:740-376-5002
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.18260363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151429Medicaid
OHH285530Medicare PIN