Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | F320034-1 | NY |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 0024166427 | VA |
NPI | 1255484226 |
---|---|
Provider Name | Melissa Ann Sutherland |
First Address | Binghamton, NY 13903-1500 |
Second Address | Binghamton, NY 13905-2424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2007 |
Last Update Date | 08/07/2007 |