| NPI | 1760831994 |
|---|---|
| Former Name | MELISSA LOUISE CAROLLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11008157) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 21190) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2021-02-10 |