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General NPI Number Information
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NPI Number | 1215988134
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Entity Type | Individual
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Provider Name | JILL A MYERS NP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 4857 STATE ROUTE 5
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City | VERNON
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State | NY
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Zip | 13476-3530
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Country | US
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Telephone | 315-363-9995
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Fax | 315-363-9686
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Provider Business Mailing Address
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Address Line | 4857 STATE ROUTE 5
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City | VERNON
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State | NY
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Zip | 13476-3530
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Country | US
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Telephone | 315-363-9995
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Fax | 315-363-9686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F331588
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License Number State | NY
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