Collin Barrett Mercuri Stage
Individual provider Active NPI Registered Nurse · Haw River, NC
NPI 1831965342 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1831965342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 302079 (NC)
- Practice address
- 808 Houston CT
Haw River, NC 27258-8853 - Phone
- (315) 720-2121
- NPI assigned
- Nov 27, 2023
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302079 | NC | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 302079 | NC | Yes |
Addresses
Primary practice location
808 Houston CT
Haw River, NC 27258-8853
Mailing address
808 Houston CT
Haw River, NC 27258-8853
Other providers in Haw River, NC
- Snjezana Joksimovic
- Lewis Leander Newman Jr.
- Pharmacure Health Center LLC
- Ralph Scott Lifeservices Inc
- Eureka Deniece Shaw
- Hannah Rose Tosch
All providers in Haw River, NC · Registered Nurse in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. 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.