Healthcare Provider Details

I. General information

NPI: 1558542001
Provider Name (Legal Business Name): DARLENE J MERRITT PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 SOUTH FOREST AVENUE #334
TEMPE AZ
85287
US

IV. Provider business mailing address

PO BOX 5199
ABILENE TX
79608-5199
US

V. Phone/Fax

Practice location:
  • Phone: 480-965-6147
  • Fax: 480-965-3426
Mailing address:
  • Phone: 866-890-6390
  • Fax: 325-437-8390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP 2809
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: