Individual provider · NPI-1

Dr. Richard Mark Merrill, Nurse Practitioner

Nurse Practitioner, Pediatrics · Apo, AE

NPI number1720458599
StatusActive
Last updated in NPPESApr 26, 2018

Details

NPI
1720458599
Entity type
Individual (NPI-1)
Name
Dr. Richard Mark Merrill
Credential
Nurse Practitioner
Sex
Male
Sole proprietor
No
Enumeration date
Oct 5, 2015
Last updated
Apr 26, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics9361765-4405UTYes
363LP0222X Nurse Practitioner, Pediatrics, Critical Care9361765-4405UT

Other names

  • Richard Mark Merrill (Professional Name)

Practice location

422 Mds/Sgn
Unit 4628
Apo, AE 09494-4628

Phone 314-236-8125

Mailing address

Psc 50 Box 563
Apo, AE 09494-0006

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