Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 35350370 | NY |
NPI | 1104209709 |
---|---|
Provider Name | Melissa Anne Mule |
First Address | Orchard Park, NY 14127-2256 |
Second Address | Buffalo, NY 14222-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2015 |
Last Update Date | 01/07/2015 |