Individual
MELINDA A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
640 ALDEN ST, MEADVILLE, PA 16335-2348
(814) 373-5266
(814) 373-5269
Mailing address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 373-5266
(814) 373-5269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP011406
PA
363LF0000X
Family Nurse Practitioner
SP011406
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP011406
PA STATE BOARD OF NURSING
PA
Enumeration date
01/30/2012
Last updated
02/02/2022
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