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Individual

SANDRA P MERTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, IBCLC

Contact information

Practice address
533 MAJESTIC PRINCE CIRCLE, HAVRE DE GRACE, MD 21078-2795
(443) 668-4377
(443) 729-0620
Mailing address
533 MAJESTIC PRINCE CIRCLE, HAVRE DE GRACE, MD 21078-2795
(443) 669-4377
(443) 729-0620

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
R198259
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1015976760001
PA
Enumeration date
03/13/2007
Last updated
07/30/2012
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