Provider Demographics
NPI:1548278658
Name:MERRYWEATHER, ERIN MARIE (NP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:MERRYWEATHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 E 530 N
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3021
Mailing Address - Country:US
Mailing Address - Phone:435-654-2019
Mailing Address - Fax:
Practice Address - Street 1:807 E SOUTH TEMPLE
Practice Address - Street 2:STE 101
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1339
Practice Address - Country:US
Practice Address - Phone:801-746-0776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT351266-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily