Provider Demographics
NPI:1023305042
Name:MERRILL-BERNATH, SUSANNAH MARION (CD(CBI))
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:MARION
Last Name:MERRILL-BERNATH
Suffix:
Gender:F
Credentials:CD(CBI)
Other - Prefix:
Other - First Name:SUSANNAH
Other - Middle Name:MARION
Other - Last Name:MERRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 ASHFORD CENTER RD
Mailing Address - Street 2:APT D8
Mailing Address - City:ASHFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06278-1424
Mailing Address - Country:US
Mailing Address - Phone:860-245-1894
Mailing Address - Fax:
Practice Address - Street 1:149 ASHFORD CENTER RD
Practice Address - Street 2:APT D8
Practice Address - City:ASHFORD
Practice Address - State:CT
Practice Address - Zip Code:06278-1424
Practice Address - Country:US
Practice Address - Phone:860-245-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula