Individual provider · Type 1 NPI

Montanna Lee Merrick, PA-C

Surgical Physician Assistant · Cheyenne, WY

NPI number 1205697315 Active

Practice location

4003 Rawlins St
Cheyenne, WY 82001-1800

Mailing address

4811 Kester St
Cheyenne, WY 82001-2085

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA1221 (WY)
Surgical Physician Assistant Primary 363AS0400XPA1221 (WY)

Surgical Physician Assistant: Definition to come...

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About NPI 1205697315

Montanna Lee Merrick, PA-C's National Provider Identifier is 1205697315, issued on Jan 17, 2024. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Cheyenne, WY. The record was last updated on Dec 13, 2024.