Provider Demographics
NPI:1346382918
Name:MERRILL, CARRIE L (DO)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:MERRILL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2621
Mailing Address - Country:US
Mailing Address - Phone:307-237-5510
Mailing Address - Fax:307-237-0607
Practice Address - Street 1:770 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2621
Practice Address - Country:US
Practice Address - Phone:307-237-5510
Practice Address - Fax:307-237-0607
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10980A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology