Individual
PENNY MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
GHS-1040 WEST BRISTOL RD, FLINT, MI 48507
(810) 701-6519
Mailing address
3043 E BAY DR, FENTON, MI 48430-1399
(810) 208-7080
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704276828
MI
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704276828
MI
Other
Enumeration date
05/23/2018
Last updated
12/02/2024
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