Provider Demographics
NPI:1881029429
Name:MERCIER, ANGELA GRACE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:GRACE
Last Name:MERCIER
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:PO BOX 602120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2120
Mailing Address - Country:US
Mailing Address - Phone:704-782-1955
Mailing Address - Fax:704-782-3903
Practice Address - Street 1:5641 POPLAR TENT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-7533
Practice Address - Country:US
Practice Address - Phone:704-782-1955
Practice Address - Fax:704-782-3903
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006463363LF0000X
NC202109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1881029429Medicaid
NCNCE892BMedicare PIN