Healthcare Provider Details

I. General information

NPI: 1073349981
Provider Name (Legal Business Name): MARGARET MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET MYERS

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 MASON AVE
DREXEL HILL PA
19026-2522
US

IV. Provider business mailing address

913 MASON AVE
DREXEL HILL PA
19026-2522
US

V. Phone/Fax

Practice location:
  • Phone: 267-370-4225
  • Fax:
Mailing address:
  • Phone: 267-370-4225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN292519
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberPN292519
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: