Provider Demographics
NPI:1114537008
Name:MERCY FAMILY HEALTH CLINIC, LLC
Entity Type:Organization
Organization Name:MERCY FAMILY HEALTH CLINIC, LLC
Other - Org Name:MERCY FAMILY HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, CRNP
Authorized Official - Phone:410-323-2300
Mailing Address - Street 1:5438 YORK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3837
Mailing Address - Country:US
Mailing Address - Phone:410-323-2300
Mailing Address - Fax:
Practice Address - Street 1:5438 YORK RD STE 101
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3837
Practice Address - Country:US
Practice Address - Phone:410-323-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty