Provider Demographics
NPI:1952581217
Name:MERRILL, SHANA L (MS)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:L
Last Name:MERRILL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HIGHLAND AVE, S.E. SUITE 455
Mailing Address - Street 2:COMMUNITY MEDICAL BUILDING, PRENATAL DIAGNOSTIC CENTER
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24013-2256
Mailing Address - Country:US
Mailing Address - Phone:540-224-6934
Mailing Address - Fax:
Practice Address - Street 1:102 HIGHLAND AVE, S.E. SUITE 455
Practice Address - Street 2:COMMUNITY MEDICAL BUILDING, PRENATAL DIAGNOSTIC CENTER
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2256
Practice Address - Country:US
Practice Address - Phone:540-224-6934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS