Healthcare Provider Details

I. General information

NPI: 1598808933
Provider Name (Legal Business Name): CHRISTINE C MERRITT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE C BARNES NP

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 EATON STREET MORRISVILLE STATE COLLEGE MATTHIAS STUDENT HEALTH CENTE
MORRISVILLE NY
13408-0901
US

IV. Provider business mailing address

BOX 901 MORRISVILLE STATE COLLEGE MATTHAIS STUDENT HEALTH CENTE
MORRISVILLE NY
13408-0901
US

V. Phone/Fax

Practice location:
  • Phone: 315-684-6078
  • Fax: 315-684-6293
Mailing address:
  • Phone: 315-684-6078
  • Fax: 315-684-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number300238
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: