AUTUMN D MERCER AGNP-C LLC (NPI# 1790241065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790241065 |
| Entity Type | Organization |
| Organization Name | AUTUMN D MERCER AGNP-C LLC |
| Practice Address |
1075 Shayla Ln Central Point OR 97502-2995 |
| Practice Telephone | 5033098026 |
| Practice Fax Number | 5419815040 |
| Mailing Telephone | 5033098026 |
| Mailing Fax Number | 5419815040 |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-02-12 |
| Authorized Official Name | AUTUMN DAWN MERCER (OWNER/OPERATOR) |
| Authorized Official Telephone | 5033098026 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500733407 | 05 |
| Street Address |
1075 SHAYLA LN |
| City | CENTRAL POINT |
| State | OR |
| Zip Code | 97502-2995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013459734 | Rebuilding Together Rogue Valley | Home Health | 421 Stone Pointe Drive, Central Point, OR 97502 | 2016-11-11 |
| 1801262431 | Kathleen Marie Vandevender | Behavioral Analyst | 153 Wind Song Drive, Central Point, OR 97502 | 2015-08-18 |
| 1356735112 | Nikole Mcewen | Behavioral Analyst | 2030 Taylor Rd, Central Point, OR 97502 | 2015-03-19 |
| 1619368636 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 200 W Pine St, Central Point, OR 97502 | 2015-02-12 |
| 1124429360 | Sarah Jean North | Massage Therapist | 2463 Saint James Way, Central Point, OR 97502 | 2014-09-08 |
| 1972928034 | Jennifer Joe-anne Marks | Registered Nurse | 312 Oak St. Ste #205, Central Point, OR 97502 | 2014-02-26 |
| 1578991527 | Lawrence Gerald Whittington | Behavioral Analyst | 6340 Honey Tree Ln., Central Point, OR 97502 | 2013-10-29 |
| 1093141582 | Samuel Joseph Hicks | Behavioral Analyst | 4434 Corey Road, Central Point, OR 97502 | 2013-09-17 |
| 1598191074 | Kathie Ellen Moss | Behavioral Analyst | 5315 Teresa Way, Central Point, OR 97502 | 2013-09-17 |
| 1831525336 | Becky Kay Lunsford | Behavioral Analyst | 640 S. 2nd Street, Family Solutions, Central Point, OR 97502 | 2013-09-17 |
| Find all providers in zip 97502 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315972 | Deborah Marie Jones | Nurse Practitioner | 15800 Boones Ferry Rd Ste A6, Lake Oswego, OR 97035-3426 | 2020-08-05 |
| 1184257115 | Joanna Rae Farrell | Nurse Practitioner | 1650 Ne 32nd Ave Apt 425, Portland, OR 97232-3455 | 2020-02-18 |
| 1023590841 | Healthy At Home LLC | Nurse Practitioner | 3910 Ne 99th Ave, Portland, OR 97220-3620 | 2018-08-29 |
| 1437648946 | Stephanie Michele Johnson | Nurse Practitioner | 3560 Se 79th Ave, Portland, OR 97206-2372 | 2018-05-09 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| 1003275843 | Catherine Chiaradonna | Nurse Practitioner | 1867 Williams Hwy Ste 226, Grants Pass, OR 97527-5856 | 2016-02-22 |
| 1801266119 | Daniel Dominic Eric Roa | Nurse Practitioner | 5316 N Greeley Ave, Portland, OR 97217-4113 | 2015-09-29 |
| 1538578067 | Karen Lee Warren | Nurse Practitioner | 727 S Wahanna Rd Ste 100, Seaside, OR 97138-7735 | 2014-08-08 |
| 1245579408 | Derek Brent Kordenbrock | Nurse Practitioner | 625 Sw Ramsey Ave Ste A, Grants Pass, OR 97527-5808 | 2013-02-07 |
| 1013260181 | Sharon Louise Benjamin | Nurse Practitioner | 2724 Harvest Ct, Forest Grove, OR 97116 | 2012-10-25 |
| Find all providers with the same taxonomy | ||||
| City | CENTRAL POINT |
| Zip Code | 97502 |
Please comment or provide details below to improve the information on AUTUMN D MERCER AGNP-C LLC.
| 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.