Individual provider · Type 1 NPI

Merrill Depetrillo, NP

Nurse Practitioner · Jasper, GA

NPI number 1366458192 Active

Practice location

1266 Highway 515 S
Jasper, GA 30143-4872

Mailing address

6010 Riley Rd
Cumming, GA 30028-5927

Specialties and licenses

TaxonomyCodeLicense
Cardiovascular Disease Physician 207RC0000XRN108911 (GA)
Nurse Practitioner Primary 363L00000XRN108911 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1366458192

Merrill Depetrillo, NP's National Provider Identifier is 1366458192, issued on Aug 1, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Jasper, GA. The record was last updated on Oct 8, 2025.