Healthcare Provider Details

I. General information

NPI: 1952163826
Provider Name (Legal Business Name): BRIANA NIKELLE MYERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 SADLER RD
TOWSON MD
21286-2970
US

IV. Provider business mailing address

603 SADLER RD
TOWSON MD
21286-2970
US

V. Phone/Fax

Practice location:
  • Phone: 443-421-5404
  • Fax:
Mailing address:
  • Phone: 443-421-5404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR259651
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: