Basic Information
| Provider Information | |||||||||
| NPI: | 1952645467 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MERCER | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 S KENNEBEC AVE | ||||||||
| Address2: | |||||||||
| City: | MCCONNELSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437561212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405254537 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1716 GIHON RD | ||||||||
| Address2: | |||||||||
| City: | PARKERSBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261019655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044855511 | ||||||||
| FaxNumber: | 3044853511 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2012 | ||||||||
| LastUpdateDate: | 11/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | C1262 | WV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.