Healthcare Provider Details

I. General information

NPI: 1821555202
Provider Name (Legal Business Name): AUNDREA LYN MERSON RESPIRATORY THERAPIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1571 HARTLY RD
HARTLY DE
19953-2761
US

IV. Provider business mailing address

1571 HARTLY RD
HARTLY DE
19953-2761
US

V. Phone/Fax

Practice location:
  • Phone: 302-423-9110
  • Fax:
Mailing address:
  • Phone: 302-423-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberC9-0000909
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: