Mary W Merritt, CNA
Individual provider Active NPI Nurse's Aide · Afton, WY
NPI 1164633244 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164633244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 2432 (WY)
- Practice address
- 540 Washington
Afton, WY 83110 - Phone
- (307) 885-3780
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2432 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R. Scott Bevan DPM PC | Past | Accepting new patients | |
| R Scott Bevan DPM PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 2432 | WY | Yes |
Addresses
Primary practice location
540 Washington
Afton, WY 83110
Mailing address
647 Allred Rd
Afton, WY 83110-9609
Phone (307) 885-3604
Other providers in Afton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.