Provider Demographics
NPI:1174295778
Name:MEHLE, MELANIE GAIL SIDRAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:GAIL SIDRAN
Last Name:MEHLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300B PRINCETON HIGHTSTOWN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1400
Mailing Address - Country:US
Mailing Address - Phone:609-448-7300
Mailing Address - Fax:609-448-8022
Practice Address - Street 1:300B PRINCETON HIGHTSTOWN RD STE 201
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1400
Practice Address - Country:US
Practice Address - Phone:609-448-7300
Practice Address - Fax:609-448-8022
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996988-NP363LF0000X
NJ26NJ01395200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily