Individual
MRS. MELISSA LYNN GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-6253
Mailing address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F308944-1
NY
Other
Enumeration date
10/22/2018
Last updated
08/22/2019
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