Provider Demographics
NPI:1619628120
Name:MERMIS, NORAH CATHERINE
Entity Type:Individual
Prefix:
First Name:NORAH
Middle Name:CATHERINE
Last Name:MERMIS
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 1:523 W KANAWHA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1437
Mailing Address - Country:US
Mailing Address - Phone:614-940-4255
Mailing Address - Fax:
Practice Address - Street 1:3620 N HIGH ST STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3693
Practice Address - Country:US
Practice Address - Phone:614-940-4255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA91731225700000X
OH33.025648225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist