Provider Demographics
NPI:1801605415
Name:ROSSI, MECHELL
Entity type:Individual
Prefix:
First Name:MECHELL
Middle Name:
Last Name:ROSSI
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:MT
Mailing Address - Zip Code:59829-0446
Mailing Address - Country:US
Mailing Address - Phone:559-381-2511
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 446
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:MT
Practice Address - Zip Code:59829-0446
Practice Address - Country:US
Practice Address - Phone:559-381-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT243924363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care