Individual
MS. JOANNE IVETTE MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
259724
MA
363LF0000X
Family Nurse Practitioner
Primary
RN259724
MA
Other
Enumeration date
07/21/2020
Last updated
03/09/2023
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