Healthcare Provider Details

I. General information

NPI: 1013133818
Provider Name (Legal Business Name): NANCY A MEYERS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 WYATT DR SUITE 1
LAS CRUCES NM
88005-2962
US

IV. Provider business mailing address

5051 RUBY MINE RD
LAS CRUCES NM
88011-9366
US

V. Phone/Fax

Practice location:
  • Phone: 505-640-5812
  • Fax:
Mailing address:
  • Phone: 505-640-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number5115
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: