Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 26NR11249000 | NJ |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NR11249000 | NJ |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 26NJ00302600 | NJ |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 26NR11249000 | NJ |
NPI | 1346550571 |
---|---|
Provider Name | Mrs. Melissa Theresa Rubin |
First Address | Red Bank, NJ 07701-5688 |
Second Address | Red Bank, NJ 07701-5688 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2010 |
Last Update Date | 30/01/2019 |