Provider Demographics
NPI:1952541401
Name:MERRITT, MICHAEL EDWIN (RN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWIN
Last Name:MERRITT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-1037
Mailing Address - Country:US
Mailing Address - Phone:740-261-5045
Mailing Address - Fax:
Practice Address - Street 1:209 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:NEW CONCORD
Practice Address - State:OH
Practice Address - Zip Code:43762-1037
Practice Address - Country:US
Practice Address - Phone:740-261-5045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN276528163W00000X
VA000129195163W00000X
FLRN9281668163W00000X
PARN602537163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse