Provider Demographics
NPI:1063724284
Name:MEYERS, STEPHANIE NICHOL (RN)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:NICHOL
Last Name:MEYERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5573 OLD BLUE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2771
Mailing Address - Country:US
Mailing Address - Phone:513-300-1180
Mailing Address - Fax:
Practice Address - Street 1:5573 OLD BLUE ROCK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2771
Practice Address - Country:US
Practice Address - Phone:513-300-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH356373163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse