Provider Demographics
NPI:1295622363
Name:MYERS, ELISA MAE (BFA)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:MAE
Last Name:MYERS
Suffix:
Gender:F
Credentials:BFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 LITTLE HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-6212
Mailing Address - Country:US
Mailing Address - Phone:540-442-0502
Mailing Address - Fax:
Practice Address - Street 1:253 LITTLE HOUSE LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-6212
Practice Address - Country:US
Practice Address - Phone:540-442-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5219374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula