Provider Demographics
NPI:1922782978
Name:ALBRIGHT, MERRIE
Entity Type:Individual
Prefix:
First Name:MERRIE
Middle Name:
Last Name:ALBRIGHT
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 1:460 S PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:BETHALTO
Mailing Address - State:IL
Mailing Address - Zip Code:62010-1816
Mailing Address - Country:US
Mailing Address - Phone:206-393-8666
Mailing Address - Fax:
Practice Address - Street 1:460 S PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010-1816
Practice Address - Country:US
Practice Address - Phone:206-393-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041542213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse