Healthcare Provider Details

I. General information

NPI: 1225045354
Provider Name (Legal Business Name): MONICA L BYERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 LANCASTER DR NE STE 110
SALEM OR
97305-1065
US

IV. Provider business mailing address

4742 LIBERTY ROAD S PMB 648
SALEM OR
97302
US

V. Phone/Fax

Practice location:
  • Phone: 503-395-8614
  • Fax:
Mailing address:
  • Phone: 702-281-6552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN001192
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number201802846NP-PP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201802846NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: