Individual
DARA MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN FNP-C
Contact information
Practice address
2804 N OAK ST STE C, VALDOSTA, GA 31602-5913
(229) 241-8925
Mailing address
291C DUNN LN, MOULTRIE, GA 31788-1797
(229) 921-7800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN141655
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161455
LICENSE
—
01
—
RN141655
LICENSE
—
Enumeration date
07/13/2021
Last updated
07/13/2021
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