MS. MARY ALICE MELWAK NP NPI 1992882906

NPI Information

NPI: 1992882906
Provider Name: MS. MARY ALICE MELWAK, NP
Classification: Nurse Practitioner - 363LN0000X
Entity Type: Individual

Specialization: Neonatal

PECOS Registration: Yes

Address:
3665 KEARNY VILLA RD STE 400
SAN DIEGO, CA
ZIP 92123
Phone: (858) 966-8801
Get Directions

MS. Mary Alice Melwak, NP is a neonatal nurse practitioner in San Diego, CA. MS. Mary Alice Melwak, NP NPI is 1992882906. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3665 KEARNY VILLA RD STE 400
SAN DIEGO, CA
ZIP 92123-955
Phone: (858) 966-8801

The NPI 1992882906 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 11/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LN0000X	Nurse Practitioner	Neonatal	APRN11026789	FLORIDA	No
2	363LP0200X	Nurse Practitioner	Pediatrics	NP15851	CALIFORNIA	No
3	363LN0000X	Nurse Practitioner	Neonatal	136096474405	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RN582127	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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