Provider Demographics
NPI:1376362756
Name:MERILLAT, DENISE (RN)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:MERILLAT
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 1:14015 SUNRISE ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7722
Mailing Address - Country:US
Mailing Address - Phone:713-887-5582
Mailing Address - Fax:
Practice Address - Street 1:14015 SUNRISE ARBOR LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7722
Practice Address - Country:US
Practice Address - Phone:713-887-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX699018163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty