Individual
ABBY MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3309 S 750 W, RUSSIAVILLE, IN 46979-9146
(765) 883-2273
Mailing address
3309 S 750 W, RUSSIAVILLE, IN 46979-9146
(765) 883-2273
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28223429A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71007187A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001097050
ANTHEM PROVIDER NUMEBR
IN
05
—
300004634
—
IN
Enumeration date
03/22/2017
Last updated
03/24/2021
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