Healthcare Provider Details

I. General information

NPI: 1912231382
Provider Name (Legal Business Name): ALANA R MERCER P.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E RIVER ST
ELYRIA OH
44035-5902
US

IV. Provider business mailing address

630 E RIVER ST
ELYRIA OH
44035-5902
US

V. Phone/Fax

Practice location:
  • Phone: 440-329-7450
  • Fax:
Mailing address:
  • Phone: 440-329-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.002946RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberPA1230
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code364SE0003X
TaxonomyEmergency Clinical Nurse Specialist
License Number50-002946
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: