Provider Demographics
NPI:1528696762
Name:MERKEL, MARK EDWARD (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:EDWARD
Last Name:MERKEL
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
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 681508
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1508
Mailing Address - Country:US
Mailing Address - Phone:615-661-7888
Mailing Address - Fax:615-661-9001
Practice Address - Street 1:1040 N JAMES M CAMPBELL BLVD STE 108
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2758
Practice Address - Country:US
Practice Address - Phone:615-661-7888
Practice Address - Fax:615-661-9001
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily