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General NPI Number Information
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NPI Number | 1376863423
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Entity Type | Individual
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Provider Name | MRS. ERICA TERESA MERRITT
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Gender | Female
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 912 BUCKHORN RD
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City | WILLARD
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State | NC
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Zip | 28478-9678
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Country | US
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Telephone | 910-631-7021
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 BLAND SCHOOL RD
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City | HARRELLS
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State | NC
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Zip | 28444-7609
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Country | US
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Telephone | 910-532-4805
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Fax | 910-532-4805
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | FCL-082-017
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL-082-025
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License Number State | NC
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