Provider Demographics
NPI:1164654695
Name:MERRITT, ERIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:LINDQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4924 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-3349
Mailing Address - Country:US
Mailing Address - Phone:262-997-9573
Mailing Address - Fax:262-997-9574
Practice Address - Street 1:4924 7TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3349
Practice Address - Country:US
Practice Address - Phone:262-997-9573
Practice Address - Fax:262-997-9574
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist