Provider Demographics
NPI:1225336696
Name:ANELLO, MELANIE MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MARIE
Last Name:ANELLO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1263
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-1263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2415 HIGH SCHOOL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1800
Practice Address - Country:US
Practice Address - Phone:925-685-8894
Practice Address - Fax:925-609-7558
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily