| Doctor Name: | DR. RICHARD MARK MERRILL |
| NPI Number: | 1720458599 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 9361765-4405 |
| Business Practice Address: | 7321 Balmer St Building 569 Hill Afb, UT - 840565012 |
| Business Phone Number: | 8017776214 |
| Business Fax Number: | |
| Mailing Address: | 7321 Balmer St, Building 569 HILL AFB |
| State: | UT |
| Postal Code: | 840565012 |
| Phone Number: | 8017776214 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2015 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0222X |
| License Number: | 9361765-4405 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics, Critical Care |
| Taxonomy Definition: | |