Provider Demographics
NPI:1710744750
Name:MERCHANT, BRISHA
Entity Type:Individual
Prefix:
First Name:BRISHA
Middle Name:
Last Name:MERCHANT
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 1:6898 SOUTHERN BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4631
Mailing Address - Country:US
Mailing Address - Phone:330-503-1006
Mailing Address - Fax:
Practice Address - Street 1:6898 SOUTHERN BLVD APT 3
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4631
Practice Address - Country:US
Practice Address - Phone:330-503-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide