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Individual

MRS. CARRIE SUE MERSEREAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
5757 MONCLOVA RD STE 26, MAUMEE, OH 43537-1863
(419) 893-5557
(419) 893-5199
Mailing address
5757 MONCLOVA RD STE 26, MAUMEE, OH 43537-1863
(419) 893-5557
(419) 893-5199

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
024233
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1164968483
NPI
OH
05
1164968483
OH
Enumeration date
01/10/2017
Last updated
12/09/2022
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