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NPI Code Detail

MEDICARE: PATRICK MYER JR. LPN

MEDICARE: PATRICK MYER JR. 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 NurseL0069689OK

General Provider Information

NPI Number : 1841895273
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK MYER JR. LPN
Provider Business Mailing Address
First Line : 1737 LINWOOD BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-5037
Country : US
Telephone Number : 405-706-8808
Fax Number : 405-278-3574
Provider Business Practice Location Address
First Line : 1737 LINWOOD BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-5037
Country : US
Telephone Number : 405-706-8808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2020
Last Update Date : 12/03/2020

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