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Individual
MRS. MELISSA HEATHER SUDDUTH
Active
Individual
MRS. MELISSA HEATHER SUDDUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SPO14806
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597586
TPI MEDICARE
PA
01
—
CD4829
TPI RAILROAD MEDICARE
PA
Enumeration date
06/16/2015
Last updated
08/27/2015
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