# DENNIS C MYERS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134123995
- **Gender:** Man
- **Credential:** NP-C, AAHIVS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 3545P | KY | — |
| 363L00000X | Nurse Practitioner | 71000351A | IN | Yes |

## Other

- **Enumeration date:** 06/09/2005
- **Last updated:** 05/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000651266 | BLUE CROSS BLUE SHIELD | IN |
| 05 | — | 200187430 | — | IN |
| 01 | — | 50013210 | PASSPORT HEALTH PLAN | KY |
| 05 | — | 78006970 | — | KY |