Provider Demographics
NPI:1407401623
Name:MERCER, LEAH RAE
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:RAE
Last Name:MERCER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LEAH
Other - Middle Name:RAE
Other - Last Name:PEPOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:634 RIVERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-1312
Mailing Address - Country:US
Mailing Address - Phone:406-590-5405
Mailing Address - Fax:
Practice Address - Street 1:634 RIVERWOOD CT
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1312
Practice Address - Country:US
Practice Address - Phone:406-590-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide