Healthcare Provider Details

I. General information

NPI: 1881829117
Provider Name (Legal Business Name): RONDA ANN MERRELL PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 W HIGHWAY 40 STE B
VERNAL UT
84078-4203
US

IV. Provider business mailing address

307 W 950 S
VERNAL UT
84078-4157
US

V. Phone/Fax

Practice location:
  • Phone: 435-250-4580
  • Fax:
Mailing address:
  • Phone: 435-790-0937
  • Fax: 435-849-8220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number858221
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5672743-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number5672743-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: