Provider Demographics
NPI:1235578261
Name:MERSON, TAMMY LYNN (RN, BSN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:MERSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14955 GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21636-1311
Mailing Address - Country:US
Mailing Address - Phone:410-924-7360
Mailing Address - Fax:410-482-9307
Practice Address - Street 1:14736 POPLAR ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:MD
Practice Address - Zip Code:21636-1307
Practice Address - Country:US
Practice Address - Phone:410-924-7360
Practice Address - Fax:410-482-9307
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR129055163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse