Provider Demographics
NPI:1114787306
Name:MILLER, MELODY A (CRNP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 WALTER RD
Mailing Address - Street 2:
Mailing Address - City:GRAMPIAN
Mailing Address - State:PA
Mailing Address - Zip Code:16838-8945
Mailing Address - Country:US
Mailing Address - Phone:814-771-3352
Mailing Address - Fax:814-583-5814
Practice Address - Street 1:WELLNOW URGENT CARE
Practice Address - Street 2:917 S ST MARYS ST
Practice Address - City:ST MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857
Practice Address - Country:US
Practice Address - Phone:814-389-1026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily