Healthcare Provider Details

I. General information

NPI: 1699749028
Provider Name (Legal Business Name): AMY C MERO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 BALLAHACK RD SUITE 100
CHESAPEAKE VA
23322-2499
US

IV. Provider business mailing address

509 BROOKLYN CT
VIRGINIA BEACH VA
23451-5874
US

V. Phone/Fax

Practice location:
  • Phone: 757-421-8220
  • Fax: 757-421-8288
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0066119
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: