Provider Demographics
NPI:1346281466
Name:MERCER, NITA T (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NITA
Middle Name:T
Last Name:MERCER
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:PO BOX 2370
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4503
Mailing Address - Country:US
Mailing Address - Phone:252-808-3696
Mailing Address - Fax:252-808-2022
Practice Address - Street 1:5059 HWY 70 W
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4503
Practice Address - Country:US
Practice Address - Phone:252-808-3696
Practice Address - Fax:252-808-3696
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000675363L00000X
NC201759NC363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003767Medicaid
NC2809151Medicare PIN
NC7003767Medicaid