Provider Demographics
NPI:1912238585
Name:MELLOR, STEPHANIE CLARE (RN)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CLARE
Last Name:MELLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4010
Mailing Address - Street 2:313 SOUTH FIFTH STREET
Mailing Address - City:ODESSA
Mailing Address - State:DE
Mailing Address - Zip Code:19730-4010
Mailing Address - Country:US
Mailing Address - Phone:302-376-4128
Mailing Address - Fax:302-378-5139
Practice Address - Street 1:1221 CEDAR LANE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9636
Practice Address - Country:US
Practice Address - Phone:302-449-5878
Practice Address - Fax:302-378-5139
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0025967163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool