Provider Demographics
NPI:1437931458
Name:MYERS, KRISTEN (ARNP, PMHNP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:ARNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 ASPEN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4485
Mailing Address - Country:US
Mailing Address - Phone:515-412-4110
Mailing Address - Fax:515-855-2550
Practice Address - Street 1:2714 ASPEN RD STE 101
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4485
Practice Address - Country:US
Practice Address - Phone:515-412-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112528163WP0808X
IAG181700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health