Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | R108634-0 | MN |
NPI | 1033290788 |
---|---|
Provider Name | Mrs. Maria Louise-Hills Melichar |
First Address | Mayer, MN 55360-9507 |
Second Address | Minneapolis, MN 55417-2309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |