1982873089 NPI number — MS. PATRICIA ANN MERCHANT MSW LICSW

Table of content: MS. PATRICIA ANN MERCHANT MSW LICSW (NPI 1982873089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982873089 NPI number — MS. PATRICIA ANN MERCHANT MSW LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MERCHANT
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BURDICK
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1982873089
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
871 WINTHROP
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE CANADA
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-232-3000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
69 W EXCHANGE ST
Provider Second Line Business Practice Location Address:
HEALTH EAST ST JAS HOSPITAL
Provider Business Practice Location Address City Name:
ST PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-232-3338
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)