Healthcare Provider Details

I. General information

NPI: 1649473125
Provider Name (Legal Business Name): VELVET ANN MEERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VELVET ANN EYNARD

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 ADAMS ST
JEFFERSON CITY MO
65101-3408
US

IV. Provider business mailing address

12320 COUNTY ROAD 4027
TEBBETTS MO
65080-1437
US

V. Phone/Fax

Practice location:
  • Phone: 573-635-1320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number115168
License Number StateMO

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: