MEDICARE: JEANNETTE YVONNE MERCER M.D.

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	207Q00000X	Family Medicine Physician	27598	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457435034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNETTE YVONNE MERCER M.D.

Provider Business Mailing Address
First Line	:	13445 VOYAGER PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-7648
Country	:	US
Telephone Number	:	719-219-0333
Fax Number	:	719-219-0320

Provider Business Practice Location Address
First Line	:	2127 E HARMONY RD STE 140
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-3406
Country	:	US
Telephone Number	:	970-297-6250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	02/26/2020

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