Provider Demographics
NPI:1346272895
Name:MERRICK, JEANNIE (RNNP)
Entity type:Individual
Prefix:
First Name:JEANNIE
Middle Name:
Last Name:MERRICK
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70368
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-0120
Mailing Address - Country:US
Mailing Address - Phone:541-683-1559
Mailing Address - Fax:541-683-1709
Practice Address - Street 1:1488 OAK STREET
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6025
Practice Address - Country:US
Practice Address - Phone:541-431-0000
Practice Address - Fax:541-344-6176
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000039473N7163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory