Individual
MRS. JOANN MERCEDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2450
Mailing address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
618865-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382480-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
618865-1
RN LICENSE
NY
01
—
F382480-1
PEDIATRIC NURSE PRACTITIONER LICENSE
NY
Enumeration date
03/18/2015
Last updated
03/19/2015
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