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General NPI Number Information
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NPI Number | 1275057325
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Entity Type | Individual
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Provider Name | TRACEY MERRIMAN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 29000 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-5219
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Country | US
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Telephone | 440-827-5559
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Fax |
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Provider Business Mailing Address
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Address Line | 5455 N MARGINAL RD APT 515
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City | CLEVELAND
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State | OH
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Zip | 44114-3951
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | APRN.CNP.021589
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN.CNP.021589
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License Number State | OH
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