Healthcare Provider Details

I. General information

NPI: 1982282901
Provider Name (Legal Business Name): MERLYN RAYMOND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9520 GEORGIA AVE
SILVER SPRING MD
20910-1436
US

IV. Provider business mailing address

1514 SHERIDAN RD NE APT 4303
ATLANTA GA
30324-5475
US

V. Phone/Fax

Practice location:
  • Phone: 301-585-3136
  • Fax:
Mailing address:
  • Phone: 347-394-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC003587
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: