Provider Demographics
NPI:1437386802
Name:MERCER, JAMES VICTOR (RN)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:VICTOR
Last Name:MERCER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:MERCER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:500 FOOTHILL DR
Mailing Address - Street 2:ROOM 2A08 (INFUSION SERVICES)
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84148-0001
Mailing Address - Country:US
Mailing Address - Phone:810-582-1565
Mailing Address - Fax:
Practice Address - Street 1:500 FOOTHILL DR
Practice Address - Street 2:ROOM 2A08 (INFUSION SERVICES)
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:810-582-1565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT343243-3102171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator