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NPI Code Detail

MEDICARE: MS. NICOLE MERCER MS, CCC-SLP

MEDICARE: MS. NICOLE MERCER MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist3187OK

General Provider Information

NPI Number : 1568155679
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE MERCER MS, CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 892373
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73189-2373
Country : US
Telephone Number : 405-601-4303
Fax Number : 405-703-9144
Provider Business Practice Location Address
First Line : 2800 NW 36TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7477
Country : US
Telephone Number : 405-601-4303
Fax Number : 405-703-9144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2023
Last Update Date : 06/02/2023

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