Individual
KATHLEEN MCCORMICK MERCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
611 S DUPONT HIGHWAY, DOVER, DE 19901-4507
(302) 741-2123
(302) 741-2007
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
L10022291
DE
363LP0200X
Pediatric Nurse Practitioner
Primary
LJ0000119
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443301700
—
MD
01
—
LJ0000119
N.P. PROFESSIONAL LICENSE
DE
Enumeration date
07/28/2006
Last updated
12/29/2011
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