Provider Demographics
NPI:1285956557
Name:MEYER, CHRISTA ANN (RN, BSN)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N 2ND ST
Mailing Address - Street 2:P.O. BOX 681
Mailing Address - City:ANNA
Mailing Address - State:OH
Mailing Address - Zip Code:45302-9585
Mailing Address - Country:US
Mailing Address - Phone:937-394-4202
Mailing Address - Fax:
Practice Address - Street 1:505 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:OH
Practice Address - Zip Code:45302-9585
Practice Address - Country:US
Practice Address - Phone:937-394-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN280487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse