Provider Demographics
NPI:1447870241
Name:MEYER, CARRIE MARIE (RN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:MARIE
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:750 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1230
Mailing Address - Country:US
Mailing Address - Phone:585-966-2000
Mailing Address - Fax:
Practice Address - Street 1:3 LUCIA CIR
Practice Address - Street 2:
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-9632
Practice Address - Country:US
Practice Address - Phone:315-558-9365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY617276163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics