Provider Demographics
NPI:1992007272
Name:MERCER, KATHY S (CNM)
Entity Type:Individual
Prefix:MISS
First Name:KATHY
Middle Name:S
Last Name:MERCER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 BALTIMORE ANNAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2455
Mailing Address - Country:US
Mailing Address - Phone:410-626-8982
Mailing Address - Fax:
Practice Address - Street 1:1454 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2455
Practice Address - Country:US
Practice Address - Phone:410-626-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC000855367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife