Healthcare Provider Details

I. General information

NPI: 1215097670
Provider Name (Legal Business Name): BERTHA GUNYON MEYER RN, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SENATE BLVD
INDIANAPOLIS IN
46202-1239
US

IV. Provider business mailing address

5054 W 13TH ST
INDIANAPOLIS IN
46224-6522
US

V. Phone/Fax

Practice location:
  • Phone: 317-962-8191
  • Fax: 317-962-2678
Mailing address:
  • Phone: 317-247-8164
  • Fax: 317-962-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberIN PROCESS
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number28065048A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: