Healthcare Provider Details

I. General information

NPI: 1922782978
Provider Name (Legal Business Name): MERRIE ALBRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 S PRAIRIE ST
BETHALTO IL
62010-1816
US

IV. Provider business mailing address

460 S PRAIRIE ST
BETHALTO IL
62010-1816
US

V. Phone/Fax

Practice location:
  • Phone: 206-393-8666
  • Fax:
Mailing address:
  • Phone: 206-393-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041542213
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209035737
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: