Provider Demographics
NPI:1043927932
Name:MERRIMAN, ALYSSA LEIGH TAYLOR
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LEIGH TAYLOR
Last Name:MERRIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 BOTKINS RD
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-4225
Mailing Address - Country:US
Mailing Address - Phone:937-244-9851
Mailing Address - Fax:
Practice Address - Street 1:5615 BOTKINS RD
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-4225
Practice Address - Country:US
Practice Address - Phone:937-244-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker