Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN091317 | GA |
NPI | 1043273923 |
---|---|
Provider Name | Ms. Karen Joan Melde |
First Address | Cumming, GA 30041-7407 |
Second Address | Cumming, GA 30041-7407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 11/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RN091317 | RN LICENSURE (01) | GA |