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NPI Code Detail

MEDICARE: KATHERINE SUE MYERS LPN

MEDICARE:   KATHERINE SUE MYERS  LPN
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
1164W00000XLicensed Practical NurseLP042406AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LP042406OTHERAZLPN

General Provider Information

NPI Number : 1225206238
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE SUE MYERS LPN
Provider Business Mailing Address
First Line : 2439 E ELMWOOD ST
Second Line :
City : MESA
State : AZ
Zip : 85213-6001
Country : US
Telephone Number : 602-604-0548
Fax Number :
Provider Business Practice Location Address
First Line : 711 E MISSOURI AVE
Second Line : SUITE 110
City : PHOENIX
State : AZ
Zip : 85014-2824
Country : US
Telephone Number : 602-604-0548
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2008
Last Update Date : 02/12/2008

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Directions to “ KATHERINE SUE MYERS LPN” Practice Location

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