Provider Demographics
NPI:1275200362
Name:VANCE, MERILEE MARIE (RN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:MERILEE
Middle Name:MARIE
Last Name:VANCE
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15992 CARMENIA DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-1212
Mailing Address - Country:US
Mailing Address - Phone:406-366-1208
Mailing Address - Fax:
Practice Address - Street 1:15992 CARMENIA DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-1212
Practice Address - Country:US
Practice Address - Phone:406-366-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95122434163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient