Provider Demographics
NPI:1306630439
Name:DENSMORE, MERRADITH (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:MERRADITH
Middle Name:
Last Name:DENSMORE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MS
Other - First Name:MERRADITH
Other - Middle Name:
Other - Last Name:DAVISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:215 S BEAVER ST
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-1203
Mailing Address - Country:US
Mailing Address - Phone:330-383-4639
Mailing Address - Fax:
Practice Address - Street 1:16761 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9400
Practice Address - Country:US
Practice Address - Phone:855-296-1286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1205497898363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health