Individual
KELLIE ANNE MELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1776 E LANCASTER AVE, PAOLI, PA 19301-1550
(610) 647-4366
Mailing address
513 RASPBERRY LN, WEST CHESTER, PA 19382-2252
(484) 832-6491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP012992
PA
Other
Enumeration date
08/25/2013
Last updated
08/25/2013
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