Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036-107405 | IL |
N | 207V00000X | Obstetrician & Gynecologist | A85943 | CA |
Y | 207VE0102X | Reproductive Endocrinologist | 2007-00448 | NC |
NPI | 1316980915 |
---|---|
Provider Name | Dr. Jennifer E. Mersereau |
First Address | Chapel Hill, NC 27599-7570 |
Second Address | Raleigh, NC 27617-8744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 30/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A859430 | (05) | CA |
I03465 | (02) | CA |