Individual
CINDA JENSEN MELLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 CENTRACARE CIR, CENTRACARE CLINIC, ST CLOUD, MN 56303-5000
(320) 654-3630
(320) 654-3657
Mailing address
1900 CENTRACARE CIR, CENTRACARE CLINIC, ST CLOUD, MN 56303-5000
(320) 654-3630
(320) 654-3657
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32044
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110409
U CARE
—
01
—
1202202
MEDICA HEALTH PLANS
—
01
—
2114179
FIRST HEALTH PLAN
—
01
—
254011
PREFERRED ONE
—
01
—
51A33JE
BLUE CROSS BLUE SHIELD
—
01
—
659588000
MEDICAL ASSISTANCE
—
01
—
763855
ARAZ GROUP
—
01
—
HP25485
HEALTH PARTNERS
—
Enumeration date
10/28/2005
Last updated
10/27/2010
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