Doctor Name: | MRS. SHELLEY MERCADAL |
NPI Number: | 1255441150 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNP |
License Number: | NP 3094 |
Business Practice Address: | 625 Hilby Ave Seaside, CA - 939555720 |
Business Phone Number: | 8313941691 |
Business Fax Number: | 8313941870 |
Mailing Address: | 1691 The Alameda, SAN JOSE |
State: | CA |
Postal Code: | 951262203 |
Phone Number: | 4082877532 |
Fax Number: | 4082870405 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | NP 3094 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |