Provider Demographics
NPI:1760146344
Name:MCCRORY, MELANIE OLIVIA
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:OLIVIA
Last Name:MCCRORY
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 1:2341 SKYLAND PLACE SOUTHEAST
Mailing Address - Street 2:APT 808
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020
Mailing Address - Country:US
Mailing Address - Phone:202-304-5260
Mailing Address - Fax:
Practice Address - Street 1:2341 SKYLAND PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3410
Practice Address - Country:US
Practice Address - Phone:202-304-5260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant