Provider Demographics
NPI:1134940661
Name:JARRELL, MERRI CAROLINE (LPN)
Entity type:Individual
Prefix:
First Name:MERRI
Middle Name:CAROLINE
Last Name:JARRELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20079 POND FORK RD
Mailing Address - Street 2:
Mailing Address - City:VAN
Mailing Address - State:WV
Mailing Address - Zip Code:25206
Mailing Address - Country:US
Mailing Address - Phone:304-550-9662
Mailing Address - Fax:
Practice Address - Street 1:135 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1219
Practice Address - Country:US
Practice Address - Phone:304-244-5458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41226164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse