Provider Demographics
NPI:1508220963
Name:MERCER, SUE
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9885 REEDER AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-8507
Mailing Address - Country:US
Mailing Address - Phone:330-614-4199
Mailing Address - Fax:
Practice Address - Street 1:9885 REEDER AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-8507
Practice Address - Country:US
Practice Address - Phone:330-614-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2539337374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide