Provider Demographics
NPI:1760608343
Name:MELLER, SHARIEVE (APRN)
Entity Type:Individual
Prefix:
First Name:SHARIEVE
Middle Name:
Last Name:MELLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 WEST MOUNT PLEASANT AVENUE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-533-1195
Mailing Address - Fax:973-533-1305
Practice Address - Street 1:513 WEST MOUNT PLEASANT AVENUE
Practice Address - Street 2:SUITE 107
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-533-1195
Practice Address - Fax:973-533-1305
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC07158300163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NC07158300OtherCDS