Provider Demographics
NPI:1972776854
Name:MYERS, ELIZABETH L (APN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:MYERS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 ALCOA HWY STE B303
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1505
Mailing Address - Country:US
Mailing Address - Phone:865-305-8761
Mailing Address - Fax:865-305-9869
Practice Address - Street 1:1928 ALCOA HWY STE B303
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1505
Practice Address - Country:US
Practice Address - Phone:865-305-8761
Practice Address - Fax:865-305-9869
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013392363LC0200X
TN13392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4220316OtherBLUECROSS BLUESHIELD
TN3341770Medicaid
TNMC1756759OtherDEA