Provider Demographics
NPI:1902980568
Name:MERRIMAN, DORA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:DORA
Middle Name:LYNN
Last Name:MERRIMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 DECKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DECKERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48427-9307
Mailing Address - Country:US
Mailing Address - Phone:810-376-4365
Mailing Address - Fax:810-648-4338
Practice Address - Street 1:212 E SANILAC AVENUE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48427
Practice Address - Country:US
Practice Address - Phone:810-648-4327
Practice Address - Fax:810-648-4338
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704145414163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health