Provider Demographics
NPI:1083688139
Name:FINOCCHAIRO, MELANIE SMITH (NP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SMITH
Last Name:FINOCCHAIRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3506
Mailing Address - Country:US
Mailing Address - Phone:912-233-0699
Mailing Address - Fax:912-691-2615
Practice Address - Street 1:815 E 68TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4709
Practice Address - Country:US
Practice Address - Phone:912-691-2614
Practice Address - Fax:912-691-2615
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN069640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S64068Medicare UPIN
GA50BBJFKMedicare ID - Type Unspecified