Individual
MRS. MELISSA D MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
132 5TH AVE W, JEROME, ID 83338-1825
(208) 324-5286
(208) 324-9815
Mailing address
132 5TH AVE W, JEROME, ID 83338-1825
(208) 324-5286
(208) 324-9815
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP1172A
ID
367A00000X
Advanced Practice Midwife
19862A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010171795
BS
ID
05
—
808284700
—
ID
01
—
NP311
BC
ID
Enumeration date
02/05/2009
Last updated
01/07/2015
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