Healthcare Provider Details

I. General information

NPI: 1942459425
Provider Name (Legal Business Name): JULIE S MERRITT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 JUNCTION HWY
KERRVILLE TX
78028
US

IV. Provider business mailing address

575 HILL COUNTRY DR
KERRVILLE TX
78028-6024
US

V. Phone/Fax

Practice location:
  • Phone: 830-258-7900
  • Fax: 830-258-7820
Mailing address:
  • Phone: 830-258-7762
  • Fax: 830-258-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201050033NP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP123228
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201040434RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: