MEDICARE: MRS. STACY R MEYERS RN, MSN

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	163W00000X	Registered Nurse	9627153	FL

General Provider Information

NPI Number	:	1669622288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STACY R MEYERS RN, MSN

Provider Business Mailing Address
First Line	:	215 HOLLAND DR
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32095-8426
Country	:	US
Telephone Number	:	757-510-8048
Fax Number	:

Provider Business Practice Location Address
First Line	:	9889 GATE PKWY N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-9228
Country	:	US
Telephone Number	:	904-300-2809
Fax Number	:

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

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	02/07/2026

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