Provider Demographics
NPI:1801382544
Name:ARDENT PSYCHIATRY LLC
Entity Type:Organization
Organization Name:ARDENT PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:MERRIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:614-398-3559
Mailing Address - Street 1:776 PEACHBLOW RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9101
Mailing Address - Country:US
Mailing Address - Phone:614-398-3559
Mailing Address - Fax:614-918-8545
Practice Address - Street 1:776 PEACHBLOW RD UNIT A
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9101
Practice Address - Country:US
Practice Address - Phone:614-398-3559
Practice Address - Fax:614-918-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021109363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1619498680OtherNPI