Provider Demographics
NPI:1134733033
Name:MERRITT, SONITA KAY
Entity type:Individual
Prefix:
First Name:SONITA
Middle Name:KAY
Last Name:MERRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3004
Mailing Address - Country:US
Mailing Address - Phone:775-683-7780
Mailing Address - Fax:
Practice Address - Street 1:780 BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3004
Practice Address - Country:US
Practice Address - Phone:775-683-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide