Provider Demographics
NPI:1841256997
Name:MYERS, CRAIG R (CRNA)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:R
Last Name:MYERS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 LONGHILL DR
Mailing Address - Street 2:APOPKA
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712
Mailing Address - Country:US
Mailing Address - Phone:407-880-7358
Mailing Address - Fax:
Practice Address - Street 1:1367 LONGHILL DR
Practice Address - Street 2:APOPKA
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712
Practice Address - Country:US
Practice Address - Phone:407-880-7358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN101194367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000547181GMedicaid
GA000547181BMedicaid
GA000547181BMedicaid
GA43ZCBWW58Medicare ID - Type Unspecified