Provider Demographics
NPI:1538779533
Name:MERKEL, KARISSA (FNP-C)
Entity type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:MERKEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 N HIGHLAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1460
Mailing Address - Country:US
Mailing Address - Phone:630-906-7801
Mailing Address - Fax:
Practice Address - Street 1:1315 N HIGHLAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1460
Practice Address - Country:US
Practice Address - Phone:630-906-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily