Provider Demographics
NPI:1073889606
Name:MYER, MICHELLE LORRAINE (DNP, RN, APRN, CPNP)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LORRAINE
Last Name:MYER
Suffix:
Gender:F
Credentials:DNP, RN, APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2046
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-2046
Mailing Address - Country:US
Mailing Address - Phone:803-898-0097
Mailing Address - Fax:803-898-0577
Practice Address - Street 1:400 OTARRE PARKWAY
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033
Practice Address - Country:US
Practice Address - Phone:803-898-0097
Practice Address - Fax:803-898-0577
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1837363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics