Provider Demographics
NPI:1255974374
Name:AMAH, MERCY (DNP)
Entity type:Individual
Prefix:DR
First Name:MERCY
Middle Name:
Last Name:AMAH
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8178 LARK BROWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6438
Mailing Address - Country:US
Mailing Address - Phone:301-256-5251
Mailing Address - Fax:410-904-5993
Practice Address - Street 1:8178 LARK BROWN RD STE 102
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6438
Practice Address - Country:US
Practice Address - Phone:301-256-5251
Practice Address - Fax:410-904-5993
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR251160363LA2200X, 261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty