Individual
ANN F MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
13407 STATE ROUTE 12, BOONVILLE, NY 13309
(315) 942-3500
(315) 942-3618
Mailing address
13407 STATE ROUTE 12, BOONVILLE, NY 13309
(315) 942-3500
(315) 942-3618
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F331641
NY
363LF0000X
Family Nurse Practitioner
Primary
F331641-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03300331641
—
NY
Enumeration date
02/02/2007
Last updated
09/04/2012
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