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General NPI Number Information
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NPI Number | 1962635227
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Entity Type | Individual
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Provider Name | MARCIA K MERBOTH APRN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 8710 FREDERICK ST SUITE 100
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City | OMAHA
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State | NE
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Zip | 68124
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Country | US
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Telephone | 402-926-2680
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Fax | 402-926-2347
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Provider Business Mailing Address
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Address Line | 5715 S 34TH ST SUITE 100
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City | LINCOLN
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State | NE
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Zip | 68516-6648
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Country | US
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Telephone | 402-926-2680
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Fax | 402-926-2347
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | IN PROCESS
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License Number State | NE
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