Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 95009075 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95009075 | CA |
NPI | 1457827768 |
---|---|
Provider Name | Melissa Leigh Fluharty |
First Address | Mariposa, CA 95338-0099 |
Second Address | Mariposa, CA 95338-9556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2018 |
Last Update Date | 15/10/2018 |