Individual
ANDREA MERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
306 20TH AVE, BLOSSVALE, NY 13308-3630
(315) 761-6806
Mailing address
306 20TH AVE, BLOSSVALE, NY 13308-3630
(315) 761-6806
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10313326
NY
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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