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General NPI Number Information
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NPI Number | 1538633748
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Entity Type | Individual
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Provider Name | MICHAEL F. MERRICK
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Gender | Male
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 1603 MORGAN ST STE 3
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City | KEOKUK
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State | IA
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Zip | 52632-3433
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Country | US
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Telephone | 319-524-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 MAINE ST
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City | QUINCY
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State | IL
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Zip | 62301-4096
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Country | US
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Telephone | 217-222-6550
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A154696
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License Number State | IA
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