Healthcare Provider Details

I. General information

NPI: 1710313598
Provider Name (Legal Business Name): JESSICA ERIN MERCER SMA-00106
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 STATE HIGHWAY 177
CAPE GIRARDEAU MO
63701-8550
US

IV. Provider business mailing address

3333 STATE HIGHWAY 177
CAPE GIRARDEAU MO
63701-8550
US

V. Phone/Fax

Practice location:
  • Phone: 573-233-2073
  • Fax:
Mailing address:
  • Phone: 573-233-2073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberSMA-00106
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: