Provider Demographics
NPI:1093199622
Name:AREMU, MERCY (RD,LDN)
Entity Type:Individual
Prefix:MRS
First Name:MERCY
Middle Name:
Last Name:AREMU
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3021
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-1968
Mailing Address - Country:US
Mailing Address - Phone:704-691-3055
Mailing Address - Fax:
Practice Address - Street 1:2330 SCENIC HWY S STE 203
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3115
Practice Address - Country:US
Practice Address - Phone:770-881-8651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2022-08-30
Deactivation Date:2020-06-26
Deactivation Code:
Reactivation Date:2022-08-10
Provider Licenses
StateLicense IDTaxonomies
NCL004135133V00000X
133VN1005X, 133VN1006X, 133VN1201X
GALD004073133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management