Individual
KIMBERLY HAGEMAN MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
30 HARRISON ST, SUITE 100, JOHNSON CITY, NY 13790-2161
(607) 763-6850
Mailing address
8986 W CREEK RD, BERKSHIRE, NY 13736-1342
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
305734
NY
Other
Enumeration date
07/01/2011
Last updated
04/23/2014
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