Healthcare Provider Details

I. General information

NPI: 1881671337
Provider Name (Legal Business Name): ELIZABETH B MEYER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 VERDAE BLVD SUITE A
GREENVILLE SC
29607-4032
US

IV. Provider business mailing address

1 INDEPENDENCE PT SUITE 212
GREENVILLE SC
29615-4545
US

V. Phone/Fax

Practice location:
  • Phone: 864-240-5009
  • Fax: 864-240-5028
Mailing address:
  • Phone: 864-797-6044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF2222
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: