Provider Demographics
NPI:1356973622
Name:MERKLE, ELIZABETH ROSE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ROSE
Last Name:MERKLE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12393 FALCON CREST CIR
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-2600
Mailing Address - Country:US
Mailing Address - Phone:954-309-8177
Mailing Address - Fax:
Practice Address - Street 1:710 15TH ST E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3236
Practice Address - Country:US
Practice Address - Phone:205-526-2053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-176503163W00000X, 363LF0000X
ALF08211323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse