Healthcare Provider Details

I. General information

NPI: 1194953448
Provider Name (Legal Business Name): MICHELLE DENISE EYLER ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E OAK RIDGE DR STE 1700
HAGERSTOWN MD
21740-7882
US

IV. Provider business mailing address

9628 CAFOXA DR
WILLIAMSPORT MD
21795-4004
US

V. Phone/Fax

Practice location:
  • Phone: 301-573-9498
  • Fax:
Mailing address:
  • Phone: 301-573-9497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN86992
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP012028
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR118578
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: