Provider Demographics
NPI:1992712012
Name:MERCIER, STEPHANIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:MERCIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 23823
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40523
Mailing Address - Country:US
Mailing Address - Phone:859-278-8772
Mailing Address - Fax:859-422-4361
Practice Address - Street 1:125 E MAXWELL ST
Practice Address - Street 2:STE 300
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508
Practice Address - Country:US
Practice Address - Phone:859-278-8772
Practice Address - Fax:859-422-4361
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1803P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000484653OtherBC BS HHC
1172642OtherCHA HHC
KY78000627Medicaid
000000489959OtherBC BS BPC
KY78000627Medicaid
000000484653OtherBC BS HHC
KY912232Medicare ID - Type UnspecifiedPARAGON FAMILY PRACTICE