| NPI | 1932624301 |
|---|---|
| Former Name | CORRINE ANN MELLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5009796) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NC MELL-YBGV3E) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-11-29 |