Basic Information
Provider Information
NPI: 1427316652
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MYERS
FirstName: JANET
MiddleName: LYNN
NamePrefix: MRS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2901 N CENTRAL AVE STE 160
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122702
CountryCode: US
TelephoneNumber: 6027474000
FaxNumber:  
Practice Location
Address1: 2901 N CENTRAL AVE STE 160
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122702
CountryCode: US
TelephoneNumber: 0267474000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2012
LastUpdateDate: 01/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP4351AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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