Individual
MRS. MELINA DOCTO CANLAS KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 PHALEN BLVD - MS 41102D, HEALTHPARTNERS SPECIALTY CENTER 401, ST. PAUL, MN 55130-5302
(651) 254-7670
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(651) 254-7676
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2007007786-21
MN
363LG0600X
Gerontology Nurse Practitioner
2007007785
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007007785
GERONTOLOGICAL NURSE PRAC
—
01
—
2007007786-21
ADULT NURSE PRACTITIONER
—
Enumeration date
04/09/2008
Last updated
12/01/2011
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