Provider Demographics
NPI:1275005381
Name:DEMERCHANT, NICOLE (CNM)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:DEMERCHANT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WYDA CT
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1918
Mailing Address - Country:US
Mailing Address - Phone:732-801-7892
Mailing Address - Fax:
Practice Address - Street 1:4 WYDA CT
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-1918
Practice Address - Country:US
Practice Address - Phone:732-801-7892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00067400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife