Individual
NICOLE A MERZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
215 CORPORATE DRIVE, SUITE A, BEAVER DAM, WI 53916
(920) 319-8231
(414) 622-3888
Mailing address
215 CORPORATE DRIVE, SUITE A, BEAVER DAM, WI 53916
(920) 926-5666
(920) 926-8763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3822-23
WI
363A00000X
Physician Assistant
3822-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679926596
—
WI
Enumeration date
07/15/2016
Last updated
05/21/2025
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