Basic Information
Provider Information
NPI: 1396315263
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYERS
FirstName: CLAIRE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 388
Address2:  
City: FISHERSVILLE
State: VA
PostalCode: 229390388
CountryCode: US
TelephoneNumber: 5402457262
FaxNumber: 5402457054
Practice Location
Address1: 57 N MEDICAL PARK DR
Address2:  
City: FISHERSVILLE
State: VA
PostalCode: 229392353
CountryCode: US
TelephoneNumber: 5402457262
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/01/2021
LastUpdateDate: 07/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X0024181756VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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