Provider Demographics
NPI:1750871836
Name:MERRITT, BRIANNA ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:ELIZABETH
Last Name:MERRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N 2ND ST BLDG F
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-4711
Mailing Address - Country:US
Mailing Address - Phone:254-501-9232
Mailing Address - Fax:254-501-9234
Practice Address - Street 1:802 N 2ND ST BLDG F
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-4711
Practice Address - Country:US
Practice Address - Phone:254-501-9232
Practice Address - Fax:254-501-9234
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker