Provider Demographics
NPI:1295362333
Name:SCIARRA, MELANIE L (NP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:SCIARRA
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 1:125 GREENTREE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7656
Mailing Address - Country:US
Mailing Address - Phone:571-278-5693
Mailing Address - Fax:571-278-5693
Practice Address - Street 1:125 GREENTREE DR STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7656
Practice Address - Country:US
Practice Address - Phone:571-278-5693
Practice Address - Fax:571-278-5693
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DELG-0001405Medicaid