Provider Demographics
NPI:1740702604
Name:MERCHANT, JANET SUE (FNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:SUE
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 ELM FLAT RD
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14757-9330
Mailing Address - Country:US
Mailing Address - Phone:716-338-8370
Mailing Address - Fax:
Practice Address - Street 1:4570 ROUTE 60
Practice Address - Street 2:
Practice Address - City:GERRY
Practice Address - State:NY
Practice Address - Zip Code:14740-9540
Practice Address - Country:US
Practice Address - Phone:716-985-4612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341930-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily