Provider Demographics
NPI:1679394068
Name:MEYER, SANDRA D (PMHNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:D
Last Name:MEYER
Suffix:
Gender:F
Credentials:PMHNP
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 114
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KS
Mailing Address - Zip Code:66078-0114
Mailing Address - Country:US
Mailing Address - Phone:785-418-9143
Mailing Address - Fax:
Practice Address - Street 1:901 E MIAMI ST
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1879
Practice Address - Country:US
Practice Address - Phone:877-279-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-83459-091363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health