Provider Demographics
NPI:1417170606
Name:MERRETT, NANCY A (NURSE PRACTIONER)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:A
Last Name:MERRETT
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:BENISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTIONER
Mailing Address - Street 1:100 PARK RD
Mailing Address - Street 2:
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255-3616
Mailing Address - Country:US
Mailing Address - Phone:940-825-3235
Mailing Address - Fax:940-825-6304
Practice Address - Street 1:90 PARK RD
Practice Address - Street 2:
Practice Address - City:NOCONA
Practice Address - State:TX
Practice Address - Zip Code:76255-3616
Practice Address - Country:US
Practice Address - Phone:940-825-3235
Practice Address - Fax:940-825-3052
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX501932363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner