Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | SP000524A | PA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP000524A | PA |
NPI | 1003847997 |
---|---|
Provider Name | Ms. Carleen Ann Myers |
First Address | York, PA 17403-2626 |
Second Address | York, PA 17403-2626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 13/02/2020 |