Individual
JENNIFER ELIZABETH MELLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
25701 SHADY LN SW, WESTERNPORT, MD 21562-2017
(301) 359-3000
Mailing address
785 ELKRIDGE LANDING RD STE 300, LINTHICUM HEIGHTS, MD 21090-2958
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R173365
MD
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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