Provider Demographics
NPI:1053966960
Name:MERCIER, SHANNNON (RN)
Entity type:Individual
Prefix:MRS
First Name:SHANNNON
Middle Name:
Last Name:MERCIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 JOHNNY CAKE HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5674
Mailing Address - Country:US
Mailing Address - Phone:401-846-1213
Mailing Address - Fax:401-324-6251
Practice Address - Street 1:127 JOHNNY CAKE HILL ROAD
Practice Address - Street 2:65 VALLEY ROAD
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5674
Practice Address - Country:US
Practice Address - Phone:401-848-6383
Practice Address - Fax:401-324-6251
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN58969163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse