Individual
KATIE MARIE MELVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13194 S CEDAR RD, CEDAR, MI 49621-9581
(231) 357-3932
Mailing address
1169 VALLEY DR, TRAVERSE CITY, MI 49685-8920
(616) 717-0247
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703105847
MI
Other
Enumeration date
11/04/2018
Last updated
11/04/2018
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