Healthcare Provider Details

I. General information

NPI: 1013540418
Provider Name (Legal Business Name): LINDSEY MERRILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E ALEX BELL RD
CENTERVILLE OH
45459-2721
US

IV. Provider business mailing address

950 E ALEX BELL RD
CENTERVILLE OH
45459-2721
US

V. Phone/Fax

Practice location:
  • Phone: 937-291-2300
  • Fax: 937-291-2303
Mailing address:
  • Phone: 937-291-2300
  • Fax: 937-291-2303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: