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NPI Code Detail

MEDICARE: MS. MARVA J. MYERS-RAY L.P.N.

MEDICARE: MS. MARVA J. MYERS-RAY L.P.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLP033065AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922145515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARVA J. MYERS-RAY L.P.N.
Provider Business Mailing Address
First Line : 8721 N 69TH AVE
Second Line : #160-1
City : PEORIA
State : AZ
Zip : 85345-8400
Country : US
Telephone Number : 602-841-7445
Fax Number : 602-841-6892
Provider Business Practice Location Address
First Line : 4510 N 37TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85019-3206
Country : US
Telephone Number : 602-336-2990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/08/2007

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