Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP30003180 | WA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP30003180 | WA |
N | 363LW0102X | Nurse Practitioner - Women's Health | AP30003180 | WA |
NPI | 1053346411 |
---|---|
Provider Name | Joey Merrifield |
First Address | Seattle, WA 98104-2420 |
Second Address | Seattle, WA 98104-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 31/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0155094 | L&I PIN (01) | WA |
9632357 | (05) | WA |
S59632 | (02) | |
UW2875 | REGENCE BLUE SHIELD PIN (01) | WA |