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General NPI Number Information
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NPI Number | 1770006454
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL MINISTRY
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 1702 CATHERINE CT
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City | AUBURN
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State | AL
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Zip | 36830-5755
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Country | US
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Telephone | 334-501-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 8897 TARA LN
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City | AUBURN
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State | AL
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Zip | 36830-8247
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Country | US
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Telephone | 334-728-9337
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LAURA BELL
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Credential | CRNP
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Telephone | 334-501-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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