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General NPI Number Information
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NPI Number | 1629197660
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Entity Type | Individual
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Provider Name | EVELYN NADINE MERRIETT APRN-C
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 8532 W CAPITOL DR STE 201 # 201
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City | MILWAUKEE
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State | WI
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Zip | 53222-1850
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Country | US
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Telephone | 414-393-4002
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Fax | 414-393-4014
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Provider Business Mailing Address
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Address Line | 8532 W CAPITOL DR STE 201 # 201 PULMEDIX ASTHMA CARE CENTER & PFT LAB.
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City | MILWAUKEE
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State | WI
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Zip | 53222-1850
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Country | US
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Telephone | 414-393-4002
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Fax | 414-393-4014
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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 | 1594
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1594 APNP
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License Number State | WI
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