Provider Demographics
NPI:1629415138
Name:FELICIONE, MELIA
Entity Type:Individual
Prefix:
First Name:MELIA
Middle Name:
Last Name:FELICIONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MCADOO
Mailing Address - State:PA
Mailing Address - Zip Code:18237-2018
Mailing Address - Country:US
Mailing Address - Phone:570-454-5233
Mailing Address - Fax:
Practice Address - Street 1:121 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:MCADOO
Practice Address - State:PA
Practice Address - Zip Code:18237-2018
Practice Address - Country:US
Practice Address - Phone:570-454-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN265683164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse