Individual
GRACE MARIE MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N. / N.P.
Contact information
Practice address
10585 N TATUM BLVD, SUITE D130, PARADISE VALLEY, AZ 85253-1073
(602) 997-7263
(602) 944-4553
Mailing address
112 E. MCDOWELL RD, PHOENIX, AZ 85006-2611
(602) 258-4951
(602) 340-1853
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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