Doctor Name: | PENNY LYNN MYERS |
NPI Number: | 1053429324 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | FL2092862 |
Business Practice Address: | 10000 Bay Pines Blvd Bay Pines, FL - 33744 |
Business Phone Number: | 7273986661 |
Business Fax Number: | |
Mailing Address: | 11635 Pinedale Ave, SEMINOLE |
State: | FL |
Postal Code: | 337727019 |
Phone Number: | 7273949590 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | FL2092862 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |