Provider Demographics
NPI:1912391103
Name:MERSMANN, MICHELLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MERSMANN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 JOE RAMSEY BLVD E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7852
Mailing Address - Country:US
Mailing Address - Phone:903-408-7700
Mailing Address - Fax:
Practice Address - Street 1:4211 JOE RAMSEY BLVD E
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7852
Practice Address - Country:US
Practice Address - Phone:903-408-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily