Provider Demographics
NPI:1326289729
Name:MERCURIUS, VALERIE ROXANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ROXANNE
Last Name:MERCURIUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 SHEFFIELD AVE
Mailing Address - Street 2:1R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-5757
Mailing Address - Country:US
Mailing Address - Phone:347-834-6504
Mailing Address - Fax:
Practice Address - Street 1:514 SHEFFIELD AVE
Practice Address - Street 2:1R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-5757
Practice Address - Country:US
Practice Address - Phone:347-834-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290574164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse