Provider Demographics
NPI:1528405107
Name:NGUYEN, MELANIE (APRN, FNP, BC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:APRN, FNP, BC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:DEWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 RYAN CT
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5122
Mailing Address - Country:US
Mailing Address - Phone:518-728-0179
Mailing Address - Fax:
Practice Address - Street 1:43 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3478
Practice Address - Country:US
Practice Address - Phone:518-262-8751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348425363LF0000X
NY314435164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse