Individual
DENNIS C MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C, AAHIVS
Contact information
Practice address
6140 E COLUMBIA ST, EVANSVILLE, IN 47715-9133
(812) 475-1948
(812) 401-1267
Mailing address
6140 E COLUMBIA ST, EVANSVILLE, IN 47715-9133
(812) 475-1948
(812) 401-1267
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3545P
KY
363L00000X
Nurse Practitioner
Primary
71000351A
IN
Other
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
Enumeration date
06/09/2005
Last updated
05/08/2014
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