Provider Demographics
NPI:1316592629
Name:MERTZ, MEGAN NICOLE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:NICOLE
Last Name:MERTZ
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 S 153RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5145
Mailing Address - Country:US
Mailing Address - Phone:402-330-5822
Mailing Address - Fax:
Practice Address - Street 1:1624 S 153RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5145
Practice Address - Country:US
Practice Address - Phone:402-330-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-04
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEF05190873363LF0000X
NE112980363LF0000X
HIF05190873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily