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General NPI Number Information
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NPI Number | 1447222419
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Entity Type | Individual
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Provider Name | JANET ROSE MERRELL MSN, APN, CNS, BC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 904 M L KING DR
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City | CENTRALIA
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State | IL
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Zip | 62801-3532
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Country | US
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Telephone | 618-533-1391
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Fax | 618-533-0012
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Provider Business Mailing Address
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Address Line | PO BOX 995860
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City | SAINT LOUIS
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State | MO
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Zip | 63195-3532
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Country | US
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Telephone | 636-498-5944
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Fax | 618-533-0012
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209-004164
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 209.004164
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License Number State | IL
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