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General NPI Number Information
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NPI Number | 1740823723
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Entity Type | Individual
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Provider Name | AUNDREA SHALISE MERCHANT APRN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 111 CLOCK TOWER CMNS
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City | BREWSTER
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State | NY
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Zip | 10509-4055
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Country | US
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Telephone | 845-279-5187
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Fax | 845-279-5168
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Provider Business Mailing Address
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Address Line | PO BOX 958
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-0958
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Country | US
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Telephone | 727-487-7066
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11004282
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License Number State | FL
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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 | APRN11004282
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 353980
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License Number State | FL
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