Provider Demographics
NPI:1487038469
Name:MERCIER, NICHOLE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:MERCIER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 S UNIVERSITY PARKS DR
Mailing Address - Street 2:APT 1105
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-6532
Mailing Address - Country:US
Mailing Address - Phone:978-995-8472
Mailing Address - Fax:
Practice Address - Street 1:2415 S UNIVERSITY PARKS DR
Practice Address - Street 2:APT 1105
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-6532
Practice Address - Country:US
Practice Address - Phone:978-995-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-19
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT59482255A2300X
NH25392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer