Provider Demographics
NPI:1942992656
Name:MERCER, STACIE LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:LYNN
Last Name:MERCER
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 1:45 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5309
Mailing Address - Country:US
Mailing Address - Phone:978-766-0698
Mailing Address - Fax:
Practice Address - Street 1:45 TOWN ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5309
Practice Address - Country:US
Practice Address - Phone:978-766-0698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2336279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily