STACEY M MERRILL (NPI# 1760012637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760012637 |
| Entity Type | Individual |
| Full Name | STACEY M MERRILL |
| Credential | APRN |
| Practice Address |
2500 W Reynolds St Pontiac IL 61764-9784 |
| Mailing Address |
1627 Chestnut St Ottawa IL 61350-1315 |
| Practice Telephone | 8158422828 |
| Mailing Telephone | 8156854419 |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2020-01-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209020094 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861885337 | Stacey Merrill | Counselor | 13 Spring St, Augusta, ME 04330-5122 | 2015-03-09 |
| Street Address |
2500 W REYNOLDS ST |
| City | PONTIAC |
| State | IL |
| Zip Code | 61764-9784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790735421 | Saint James Hospital | Emergency Medicine | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2006-05-11 |
| 1003421660 | Emily Ruff | Occupational Therapist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2020-09-10 |
| 1699325514 | Brittany Nicole Bursott | Nurse Practitioner | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2019-09-12 |
| 1912561960 | Tessa Claire Hayes | Nurse Practitioner | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2019-04-25 |
| 1346708435 | Karissa Ann Neihouser | Physical Therapist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2019-03-07 |
| 1659848612 | Melissa Horning | Specialist/Technologist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-10-29 |
| 1497221840 | Allison Lynn Perkins | Occupational Therapist | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-10-23 |
| 1255818258 | Justin Ray Hayes | Registered Nurse | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-07-23 |
| 1083104137 | Nicole M. Jack | Physician Assistant | 2500 W Reynolds St, Pontiac, IL 61764 | 2018-05-15 |
| 1154828440 | Lorrie R. Harmon | Nurse Practitioner | 2500 W Reynolds St, Pontiac, IL 61764-9774 | 2018-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497165211 | Barbara Kay Browning | Counselor | 310 E. Torrance Ave, Pontiac, IL 61764 | 2014-05-01 |
| 1407287121 | Institute for Human Resources of Livingston County, Il | Community/Behavioral Health | 301 E Torrance Ave, Pontiac, IL 61764 | 2013-12-05 |
| 1982031241 | Annette G Franzen | Psychologist | 700 W Lincoln St # 406, Pontiac, IL 61764 | 2013-10-02 |
| 1871739185 | Woodridge of Ponitac LLC | Assisted Living Facility | 120 North Deerfield Road, Pontiac, IL 61764 | 2008-12-17 |
| 1861601171 | William Earl Hammond | Chiropractor | 210b Ladd, Pontiac, IL 61764 | 2007-05-22 |
| 1932259983 | Amy Duffy | Counselor | 210 W Water St Ste 1, Pontiac, IL 61764 | 2007-01-11 |
| 1326123340 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1034 W. Reynolds Street, Pontiac, IL 61764 | 2006-10-26 |
| 1205932977 | Gary Merl Leverton | Dentist | 518 West Madison St, Pontiac, IL 61764 | 2006-09-16 |
| 1891899886 | Robert E Heins | Family Medicine | 520 West Madison, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| Find all providers in zip 61764 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710538947 | Kaitlyn Elizabeth Kus | Nurse Practitioner | 64 N Saginaw St, Pontiac, MI 48342-2155 | 2019-09-29 |
| 1174096887 | Lisa Anne Brannack | Nurse Practitioner | 989 University Dr Ste 101, Pontiac, MI 48342-1885 | 2019-01-04 |
| 1457850414 | Krystal Richardson | Nurse Practitioner | 461 W. Huron Suite 107, Pontiac, MI 48341 | 2018-02-06 |
| 1356866842 | Brandi Jones | Nurse Practitioner | 1296 Oaklawn Dr, Pontiac, MI 48341-3604 | 2017-08-07 |
| 1821466277 | Cheryl Elaine Nickolaou | Nurse Practitioner | 46156 Woodward Ave Ste B, Pontiac, MI 48342-5033 | 2015-09-02 |
| 1962000539 | Belinda Becker | Nurse Practitioner | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-10-15 |
| 1427661552 | Gloria Ann Przygoda | Nurse Practitioner | 1506 W Reynolds St, Pontiac, IL 61764-9674 | 2020-08-28 |
| 1932729274 | Justin Rodnez | Nurse Practitioner | 181 State St, Pontiac, MI 48341-1453 | 2020-04-16 |
| 1154968667 | Samantha M Johnson | Nurse Practitioner | 50 N Perry St, Pontiac, MI 48342-2217 | 2019-12-03 |
| 1649824681 | Marisa Stroster | Nurse Practitioner | 50 N Perry St, Pontiac, MI 48342-2217 | 2019-07-29 |
| Find all providers in PONTIAC | ||||
Please comment or provide details below to improve the information on STACEY M MERRILL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.