Individual
MELISSA CATHERINE STATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
436 5TH & TED STEVENS WAY, KOTZEBUE, AK 99752-0043
(907) 442-3321
(907) 442-7250
Mailing address
PO BOX 1089, KOTZEBUE, AK 99752-1089
(907) 442-2544
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
922
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295993376
—
AZ
05
—
1629236716
—
AZ
05
—
1780614008
—
AZ
05
—
1871523191
—
AZ
Enumeration date
08/05/2006
Last updated
03/01/2012
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