Healthcare Provider Details

I. General information

NPI: 1659265288
Provider Name (Legal Business Name): MICHAELA MERZ EMT-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 1ST ST
ROSWELL NM
88203-4668
US

IV. Provider business mailing address

200 W 1ST ST
ROSWELL NM
88203-4668
US

V. Phone/Fax

Practice location:
  • Phone: 505-600-3068
  • Fax:
Mailing address:
  • Phone: 505-600-3068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number24000055
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: