Provider Demographics
NPI:1235188236
Name:MERRY, SANDRA L (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:MERRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:MACAULAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-775-0000
Mailing Address - Fax:603-778-2491
Practice Address - Street 1:21 HAMPTON RD BLDG 3
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4831
Practice Address - Country:US
Practice Address - Phone:603-775-0000
Practice Address - Fax:603-775-0247
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH048989-23363LF0000X
MA234695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3100979Medicaid
NH30005062Medicaid
MA3009068Medicaid