Basic Information
Provider Information
NPI: 1730424755
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYER
FirstName: BRITTANY
MiddleName: EVE
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 N ACADEMY AVE
Address2:  
City: DANVILLE
State: PA
PostalCode: 178224903
CountryCode: US
TelephoneNumber: 5706484010
FaxNumber:  
Practice Location
Address1: 4203 HOSPITAL RD
Address2:  
City: COAL TOWNSHIP
State: PA
PostalCode: 178669668
CountryCode: US
TelephoneNumber: 5706484010
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/03/2012
LastUpdateDate: 08/31/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/31/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XMA055898PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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