Provider Demographics
NPI:1003638941
Name:MELLMAN, ANNA RACHAEL (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:RACHAEL
Last Name:MELLMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3818
Mailing Address - Country:US
Mailing Address - Phone:303-949-5147
Mailing Address - Fax:
Practice Address - Street 1:4700 HALE PKWY STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4026
Practice Address - Country:US
Practice Address - Phone:720-320-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1000108-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily