MEDICARE: MRS. JANAI MARIE MEYER R.D., IBCLC

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	133V00000X	Registered Dietitian	40	AK
2	174N00000X	Lactation Consultant (Non-RN)	L-45481	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932108347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANAI MARIE MEYER R.D., IBCLC

Provider Business Mailing Address
First Line	:	130 CARLANNA LAKE RD LOWR
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-5611
Country	:	US
Telephone Number	:	907-220-9920
Fax Number	:	907-220-9925

Provider Business Practice Location Address
First Line	:	130 CARLANNA LAKE RD LOWR
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-5611
Country	:	US
Telephone Number	:	907-220-9920
Fax Number	:	907-220-9925

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/13/2015

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