Provider Demographics
NPI:1003188236
Name:WIERMAN, MERCEDES D (ARNP)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:D
Last Name:WIERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 PALM SPRINGS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7854
Mailing Address - Country:US
Mailing Address - Phone:407-331-1121
Mailing Address - Fax:
Practice Address - Street 1:631 PALM SPRINGS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7854
Practice Address - Country:US
Practice Address - Phone:407-331-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1266942363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily