Provider Demographics
NPI:1710370200
Name:MERRITT, TRINITY
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRINITY
Other - Middle Name:
Other - Last Name:BLIZZARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:608 D ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:OK
Mailing Address - Zip Code:74339-3110
Mailing Address - Country:US
Mailing Address - Phone:918-919-1209
Mailing Address - Fax:
Practice Address - Street 1:111 S TREATY RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-5327
Practice Address - Country:US
Practice Address - Phone:918-786-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist