Individual
MR. KENNETH ELWOOD MYERS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2501 N 3RD ST, HARRISBURG, PA 17110-1904
(717) 782-2100
(717) 782-2121
Mailing address
2501 N 3RD ST FL 2, HARRISBURG, PA 17110-1904
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP014352
PA
363LF0000X
Family Nurse Practitioner
RN591486
PA
363LF0000X
Family Nurse Practitioner
Primary
SP014352
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102975011
—
PA
Enumeration date
10/21/2014
Last updated
12/15/2020
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