Provider Demographics
NPI:1699297648
Name:MEYER, ISAIAH (NP)
Entity type:Individual
Prefix:
First Name:ISAIAH
Middle Name:
Last Name:MEYER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ANTHONY AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8089
Mailing Address - Country:US
Mailing Address - Phone:207-544-8411
Mailing Address - Fax:207-888-1044
Practice Address - Street 1:108 ANTHONY AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8089
Practice Address - Country:US
Practice Address - Phone:207-544-8411
Practice Address - Fax:207-888-1044
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP161149363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner