Provider Demographics
NPI:1548216005
Name:EGAN MERKLEY, PAMELA ANN (APRN-BC, FNP-C)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:EGAN MERKLEY
Suffix:
Gender:F
Credentials:APRN-BC, FNP-C
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:E
Other - Last Name:MERKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-BC, FNP-C
Mailing Address - Street 1:1975 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-4513
Mailing Address - Country:US
Mailing Address - Phone:801-882-3609
Mailing Address - Fax:
Practice Address - Street 1:10 CADILLAC DR STE 350
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5095
Practice Address - Country:US
Practice Address - Phone:615-372-0069
Practice Address - Fax:855-307-6412
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT200053-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000063232Medicare PIN