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General NPI Number Information
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NPI Number | 1760905004
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Entity Type | Individual
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Provider Name | CARRI J MYERS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 68 FOURTH AVE
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City | DECATUR
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State | MS
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Zip | 39327-9713
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Country | US
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Telephone | 601-635-3006
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Fax | 601-635-3007
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Provider Business Mailing Address
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Address Line | 68 FOURTH AVE
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City | DECATUR
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State | MS
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Zip | 39327-9713
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Country | US
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Telephone | 16-635-3006
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Fax | 601-635-3007
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 902140
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 902140
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License Number State | MS
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