Provider Demographics
NPI:1083777031
Name:STRINGFELLOW, MERNI T (ARNP)
Entity Type:Individual
Prefix:
First Name:MERNI
Middle Name:T
Last Name:STRINGFELLOW
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 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-326-7342
Mailing Address - Fax:386-325-1086
Practice Address - Street 1:405 ELM STREET
Practice Address - Street 2:
Practice Address - City:WELAKA
Practice Address - State:FL
Practice Address - Zip Code:32193
Practice Address - Country:US
Practice Address - Phone:386-467-3171
Practice Address - Fax:386-467-3174
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1004822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303131401Medicaid
FLARNP1004822OtherMEDICAL LICENSE
FL303131401Medicaid
FLE6142ZMedicare PIN