Provider Demographics
NPI:1679921886
Name:OYERINDE, MERCY (NP)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:OYERINDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:EMETULU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4742 LANTEN COURT.
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038
Mailing Address - Country:US
Mailing Address - Phone:678-761-5287
Mailing Address - Fax:
Practice Address - Street 1:4742 LANTEN COURT.
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038
Practice Address - Country:US
Practice Address - Phone:678-761-5287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN209449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily