Individual
MRS. KELLY ELIZABETH MERRIMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11325 LILLIAN HWY, PENSACOLA, FL 32506-8330
(850) 319-2200
Mailing address
10680 SQUALL LINE RD, PENSACOLA, FL 32507-2157
(850) 319-2200
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA 37541
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2144
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/24/2008
Last updated
08/12/2015
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