Individual
JANET ROSE MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APN, CNS, BC
Contact information
Practice address
904 M L KING DR, CENTRALIA, IL 62801-3532
(618) 533-1391
(618) 533-0012
Mailing address
PO BOX 995860, SAINT LOUIS, MO 63195-3532
(636) 498-5944
(618) 533-0012
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209-004164
IL
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
209.004164
IL
Other
Enumeration date
02/03/2006
Last updated
10/20/2020
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