Individual
LISA MELVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2 DUDLEY ST, SUITE 470, PROVIDENCE, RI 02905-3236
(401) 272-1800
(401) 868-2300
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NPP37658
RI
363LA2200X
Adult Health Nurse Practitioner
206157
MA
Other
Enumeration date
03/27/2007
Last updated
01/09/2012
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