Individual
CARLY MELISSA MADORE
Active
Individual
CARLY MELISSA MADORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
004830
CT
363LP0200X
Pediatric Nurse Practitioner
4830
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396012498
—
CT
01
—
D400170759
MEDICARE- NGS
CT
Enumeration date
11/18/2011
Last updated
09/25/2015
Update your record
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