Healthcare Provider Details

I. General information

NPI: 1477732956
Provider Name (Legal Business Name): SANDRA LYNN MERKEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5888 HIGHLAND RD SANDRA MERKEL
HIGHLAND HTS OH
44143
US

IV. Provider business mailing address

5888 HIGHLAND RD SANDRA MERKEL
HIGHLAND HTS OH
44143
US

V. Phone/Fax

Practice location:
  • Phone: 440-442-4122
  • Fax:
Mailing address:
  • Phone: 440-442-4122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number313238RN
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: