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Individual
GRACE MARIE MELLEN
Active
Individual
GRACE MARIE MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N. / N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN120100
AZ
363LA2200X
Adult Health Nurse Practitioner
AP7444
AZ
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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