Provider Demographics
NPI:1881829117
Name:MERRELL, RONDA ANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:ANN
Last Name:MERRELL
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W 950 S
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-4157
Mailing Address - Country:US
Mailing Address - Phone:435-790-0937
Mailing Address - Fax:435-849-8220
Practice Address - Street 1:185 N VERNAL AVE
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2100
Practice Address - Country:US
Practice Address - Phone:435-789-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5672743-3102163W00000X
NV8582212084P0800X
TX10899182084P0800X
UT5672743-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry