Provider Demographics
NPI:1316080146
Name:MYERS, MEREDITH A (PNP)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:MYERS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:A
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:PO BOX 626
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-985-8459
Practice Address - Street 1:3 SHAPE DR
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6601
Practice Address - Country:US
Practice Address - Phone:207-467-8930
Practice Address - Fax:207-985-8459
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81663363LP0200X, 363L00000X
MER041189363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30346785Medicaid
ME432994999Medicaid
ME000677501Medicare PIN