MEDICARE: MERCERNPSERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner
2	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1245793413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCERNPSERVICES LLC

Provider Business Mailing Address
First Line	:	680 PREDDY CREEK RD
Second Line	:
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2826
Country	:	US
Telephone Number	:	434-882-4950
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 PREDDY CREEK RD
Second Line	:
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2826
Country	:	US
Telephone Number	:	434-882-4950
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DAVID MERCER
Credential	:
Telephone Number	:	434-882-4950

Provider Enumeration Date	:	04/12/2019
Last Update Date	:	12/15/2023

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