Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 0101262264 | VA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 0101262264 | VA |
NPI | 1134385255 |
---|---|
Provider Name | Dr. Katherine Marie Mercy |
First Address | Leesburg, VA 20176-2704 |
Second Address | Leesburg, VA 20176-1707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2008 |
Last Update Date | 26/04/2021 |