Provider Demographics
NPI:1376679928
Name:MERRILL, NANCY P (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:P
Last Name:MERRILL
Suffix:
Gender:F
Credentials:DC
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 768
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY
Mailing Address - State:ME
Mailing Address - Zip Code:04537-0768
Mailing Address - Country:US
Mailing Address - Phone:207-633-3194
Mailing Address - Fax:207-633-3194
Practice Address - Street 1:21 COMMON DR
Practice Address - Street 2:
Practice Address - City:BOOTHBAY
Practice Address - State:ME
Practice Address - Zip Code:04537-4600
Practice Address - Country:US
Practice Address - Phone:207-633-3194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor