Provider Demographics
NPI:1689457467
Name:MERRIMAN, DONNA (PMHNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MERRIMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44610-0447
Mailing Address - Country:US
Mailing Address - Phone:704-685-0172
Mailing Address - Fax:
Practice Address - Street 1:615 SAINT GEORGE SQUARE CT STE 300
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1368
Practice Address - Country:US
Practice Address - Phone:800-442-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023088969363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health