Provider Demographics
NPI:1366974842
Name:MEYER, VIRGINIA DIANE (NP)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:DIANE
Last Name:MEYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FM 1488 RD
Mailing Address - Street 2:APT 1548
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3983
Mailing Address - Country:US
Mailing Address - Phone:713-408-3394
Mailing Address - Fax:
Practice Address - Street 1:245 FM 1488 RD
Practice Address - Street 2:APT 1548
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3983
Practice Address - Country:US
Practice Address - Phone:713-408-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133694363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care