Provider Demographics
NPI:1255974416
Name:MELEGARI, JASON (RN)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MELEGARI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SUTERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15083-1212
Mailing Address - Country:US
Mailing Address - Phone:304-639-0016
Mailing Address - Fax:
Practice Address - Street 1:141 KEY AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-7410
Practice Address - Country:US
Practice Address - Phone:304-242-5642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101896163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent