Provider Demographics
NPI:1619498680
Name:MERRIMAN, DAVID TODD (CNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:TODD
Last Name:MERRIMAN
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 PEACHBLOW RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9101
Mailing Address - Country:US
Mailing Address - Phone:614-398-3559
Mailing Address - Fax:614-918-8545
Practice Address - Street 1:776 PEACHBLOW RD UNIT A
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9101
Practice Address - Country:US
Practice Address - Phone:614-398-3559
Practice Address - Fax:614-918-8545
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021109363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health