Provider Demographics
NPI:1285822692
Name:MERRELL, JANET (FNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:MERRELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALMON
Mailing Address - State:ID
Mailing Address - Zip Code:83467-4512
Mailing Address - Country:US
Mailing Address - Phone:208-756-2211
Mailing Address - Fax:208-756-8700
Practice Address - Street 1:1911 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALMON
Practice Address - State:ID
Practice Address - Zip Code:83467-4512
Practice Address - Country:US
Practice Address - Phone:208-756-2211
Practice Address - Fax:208-756-8700
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-827A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily