Individual
MELISSA MULDOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 SHENNUM DR, WASILLA, AK 99654-7718
(907) 352-1200
(907) 352-1249
Mailing address
PO BOX 876505, WASILLA, AK 99687-6505
(907) 352-1200
(907) 352-1249
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM4510
—
AK
Enumeration date
05/02/2007
Last updated
07/09/2007
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