Provider Demographics
NPI:1598808933
Name:MERRITT, CHRISTINE C (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:MERRITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:C
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:BOX 901
Mailing Address - Street 2:MORRISVILLE STATE COLLEGE MATTHAIS STUDENT HEALTH CENTE
Mailing Address - City:MORRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13408-0901
Mailing Address - Country:US
Mailing Address - Phone:315-684-6078
Mailing Address - Fax:315-684-6493
Practice Address - Street 1:80 EATON STREET
Practice Address - Street 2:MORRISVILLE STATE COLLEGE MATTHIAS STUDENT HEALTH CENTE
Practice Address - City:MORRISVILLE
Practice Address - State:NY
Practice Address - Zip Code:13408-0901
Practice Address - Country:US
Practice Address - Phone:315-684-6078
Practice Address - Fax:315-684-6293
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300238363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01272848Medicaid