Provider Demographics
NPI:1740902774
Name:BENTLEY-MELLE, ANDREA MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MICHELLE
Last Name:BENTLEY-MELLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MICHELLE
Other - Last Name:BENTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:306 SOUTHFIELD LANE
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458
Mailing Address - Country:US
Mailing Address - Phone:603-341-8710
Mailing Address - Fax:
Practice Address - Street 1:306 SOUTHFIELD LANE
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458
Practice Address - Country:US
Practice Address - Phone:603-341-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047765-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily