Most Relevant Information
Provider Data
| NPI Number: | 1003291667 |
| Provider Name: | ANDREA MERRELL LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 10313326 |
Most Important Dates
| Enumeration Date: | 07/24/2015 |
| Last Updated: | 07/24/2015 |
Provider Practice Location
306 20TH AVE
BLOSSVALE
NY
133083630
Practice Location Phone/Fax
| Phone: | 3157616806 |
| Fax: |
Provider Mailing Location
306 20TH AVE
BLOSSVALE
NY
133083630
Provider Mailing Phone/Fax
| Phone: | 3157616806 |
| Fax: |