Individual
MELISSA MAZZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-6400
Mailing address
3222 S DEARBORN LN, SPOKANE, WA 99223-1535
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
72444
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2019
Last updated
08/11/2022
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