Provider Demographics
NPI:1770774929
Name:MERSFELDER, TRACEY L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:L
Last Name:MERSFELDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1521 GULL RD
Mailing Address - Street 2:BORGESS MEDICAL CENTER - DEPT OF PHARMACY FSU
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1640
Mailing Address - Country:US
Mailing Address - Phone:269-226-5019
Mailing Address - Fax:
Practice Address - Street 1:1521 GULL RD
Practice Address - Street 2:BORGESS MEDICAL CENTER - DEPT OF PHARMACY FSU
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1640
Practice Address - Country:US
Practice Address - Phone:269-226-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020328171835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy