Healthcare Provider Details

I. General information

NPI: 1821871062
Provider Name (Legal Business Name): CHRISTOPHER LAWRENCE MERCER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 05/21/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WASHINGTON ST STE 300-158
VALPARAISO IN
46383-4768
US

IV. Provider business mailing address

11850 HIGH CLOISTER CT.
FISHERS IN
46037
US

V. Phone/Fax

Practice location:
  • Phone: 765-760-1640
  • Fax:
Mailing address:
  • Phone: 765-760-1640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2023064106
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71014663A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: