Provider Demographics
NPI:1679563456
Name:CORDORO, MELANIE (CRNP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CORDORO
Suffix:
Gender:F
Credentials:CRNP
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Other - Credentials:
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:BLDG 19, DECK 3, ROOM 3657
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5630
Mailing Address - Country:US
Mailing Address - Phone:301-319-2112
Mailing Address - Fax:301-295-0981
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:BLDG 19, DECK 3, ROOM 3657
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5630
Practice Address - Country:US
Practice Address - Phone:301-319-2112
Practice Address - Fax:301-295-0981
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDAC000269363LA2200X
VA0024166805363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health