Provider Demographics
NPI:1225684442
Name:MOST, MERCEDES NICOLE
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:NICOLE
Last Name:MOST
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 1:2700 N PRICKETT RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-7511
Mailing Address - Country:US
Mailing Address - Phone:501-213-0594
Mailing Address - Fax:
Practice Address - Street 1:5410 LANDERS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-1935
Practice Address - Country:US
Practice Address - Phone:501-945-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR422318224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant