Provider Demographics
NPI:1144862442
Name:MEYERS, ROBERT CHRIS (NP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRIS
Last Name:MEYERS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 BROAD AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2460
Mailing Address - Country:US
Mailing Address - Phone:228-867-4855
Mailing Address - Fax:228-867-4810
Practice Address - Street 1:1340 BROAD AVE STE 440
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2460
Practice Address - Country:US
Practice Address - Phone:228-867-4855
Practice Address - Fax:228-867-4810
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903516363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner