Healthcare Provider Details

I. General information

NPI: 1003586363
Provider Name (Legal Business Name): KAREN MERZENICH CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARTLE CT
NAPA CA
94559-4078
US

IV. Provider business mailing address

2910 LAKE ST
SAN FRANCISCO CA
94121-1022
US

V. Phone/Fax

Practice location:
  • Phone: 707-254-1775
  • Fax:
Mailing address:
  • Phone: 415-205-9068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95174102
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95018166
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: