Individual
MELISSA LEAH COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP/AGACNP-BC
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(443) 472-3395
Mailing address
507 S 8TH ST APT 204, PHILADELPHIA, PA 19147-1356
(443) 472-3395
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP025533
PA
363LG0600X
Gerontology Nurse Practitioner
26NJ15060900
NJ
Other
Enumeration date
04/02/2022
Last updated
07/02/2025
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