Provider Demographics
NPI:1356425656
Name:MERRITT, JEANETTE (RN)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 MCSHANN RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1708
Mailing Address - Country:US
Mailing Address - Phone:972-239-0900
Mailing Address - Fax:214-857-1719
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:MAILING SYMBOL 18HBPC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-857-0426
Practice Address - Fax:214-857-1719
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX414021163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health