| NPI | 1811642242 |
|---|---|
| Former Name | MELANIE JOY DEARDO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0997203) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 0997203) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CO 0997203) | |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |