Charles Mertz, RN

Individual provider Active NPI Registered Nurse · Ponca City, OK

NPI 1629217013 · NPPES record last updated Feb 9, 2009

Key facts

NPI
1629217013
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
0080905 (OK)
Practice address
13 Hillcrest Dr
Ponca City, OK 74604-4808
Phone
(580) 765-1777
NPI assigned
Feb 9, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0080905OKMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0080905 OK Yes

Addresses

Primary practice location

13 Hillcrest Dr
Ponca City, OK 74604-4808

Mailing address

81 Stoneridge Rd
Ponca City, OK 74604-3418
Phone (580) 762-2997

Other providers in Ponca City, OK

All providers in Ponca City, OK · Registered Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.