Provider Demographics
NPI:1902060817
Name:MYERS, JOLYNNE (APRN)
Entity Type:Individual
Prefix:MS
First Name:JOLYNNE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 MAINE ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1393
Mailing Address - Country:US
Mailing Address - Phone:785-841-7297
Mailing Address - Fax:785-856-0375
Practice Address - Street 1:346 MAINE ST
Practice Address - Street 2:SUITE 150
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1393
Practice Address - Country:US
Practice Address - Phone:785-841-7297
Practice Address - Fax:785-856-0375
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44538363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health