MEDICARE: MS. NANCY A MEYERS LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	5115	NM

General Provider Information

NPI Number	:	1013133818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY A MEYERS LMT

Provider Business Mailing Address
First Line	:	5051 RUBY MINE RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9366
Country	:	US
Telephone Number	:	505-640-5812
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 WYATT DR
Second Line	:	SUITE 1
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2962
Country	:	US
Telephone Number	:	505-640-5812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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