Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 7899 | MN |
NPI | 1033712104 |
---|---|
Provider Name | Meghann Mary Malecha |
First Address | Northfield, MN 55057-3081 |
Second Address | Northfield, MN 55057-3081 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2020 |
Last Update Date | 19/11/2020 |