Healthcare Provider Details

I. General information

NPI: 1417178732
Provider Name (Legal Business Name): SUZANNE MICHELLE MEYERS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 MIDFIELD SERVICE RD SAFETY ORIENTATION TRAILER
INDIANAPOLIS IN
46241-3619
US

IV. Provider business mailing address

1694 WILLIAMSBURG LN
FRANKLIN IN
46131-1900
US

V. Phone/Fax

Practice location:
  • Phone: 317-487-4175
  • Fax: 317-487-7282
Mailing address:
  • Phone: 317-736-6442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71002171
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: