Provider Demographics
NPI:1568466084
Name:MERCER, RENEE JUNE (MSN, CPNP)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:JUNE
Last Name:MERCER
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Gender:F
Credentials:MSN, CPNP
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Mailing Address - Street 1:17737 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-3631
Mailing Address - Country:US
Mailing Address - Phone:301-774-1349
Mailing Address - Fax:301-774-7982
Practice Address - Street 1:8186 LARK BROWN RD
Practice Address - Street 2:STE 202
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6420
Practice Address - Country:US
Practice Address - Phone:301-774-1349
Practice Address - Fax:301-774-7982
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR094660363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR094660OtherSTATE NP LICENSE