Shawna Renee Myers, RDH

Individual provider Active NPI Dental Hygienist · Ellington, MO

NPI 1154504686 · NPPES record last updated Dec 6, 2007

Key facts

NPI
1154504686
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
2003015251 (MO)
Practice address
110 South 2ND Street
Ellington, MO 63638-0157
Phone
(573) 663-2313
Fax
(573) 663-2322
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2003015251MOMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2003015251 MO Yes

Addresses

Primary practice location

110 South 2ND Street
Ellington, MO 63638-0157

Mailing address

110 South 2ND Street
PO Box 157
Ellington, MO 63638-0157
Phone (573) 663-2313

Other providers in Ellington, MO

All providers in Ellington, MO · Dental Hygienist in Missouri

Sources for this page

Verify at the official NPI Registry.