Healthcare Provider Details

I. General information

NPI: 1780865048
Provider Name (Legal Business Name): YVONNE TOLSON-MYERS R.N., M.S.N.C-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/04/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 COLLIERS WAY
WEIRTON WV
26062-5012
US

IV. Provider business mailing address

485 COLLIERS WAY
WEIRTON WV
26062-5012
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-4260
  • Fax: 304-723-4264
Mailing address:
  • Phone: 304-723-4260
  • Fax: 304-723-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.04134-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0239324-22
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28420
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: