Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 71004532A | IN |
NPI | 1235424482 |
---|---|
Provider Name | Christen A Merkler |
First Address | Fort Wayne, IN 46845-1703 |
Second Address | Fort Wayne, IN 46845-1701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 02/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201176410 | (05) | IN |
3154938 | (05) | OH |