Provider Demographics
NPI:1992843809
Name:MERRITT, NANCY CHRISTENE (DO)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:CHRISTENE
Last Name:MERRITT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 689
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-0689
Mailing Address - Country:US
Mailing Address - Phone:918-635-3545
Mailing Address - Fax:918-635-3516
Practice Address - Street 1:104 WALL ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4405
Practice Address - Country:US
Practice Address - Phone:918-635-3545
Practice Address - Fax:918-635-3516
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4429207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics