Provider Demographics
NPI:1952645467
Name:MERCER, NANCY (OTA/L)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S KENNEBEC AVE
Mailing Address - Street 2:
Mailing Address - City:MCCONNELSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43756-1212
Mailing Address - Country:US
Mailing Address - Phone:740-525-4537
Mailing Address - Fax:
Practice Address - Street 1:1716 GIHON RD
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-9655
Practice Address - Country:US
Practice Address - Phone:304-485-5511
Practice Address - Fax:304-485-3511
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVC1262224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant