Doctor Name: | MELANIE ALEXIS PRIEBE |
NPI Number: | 1255417861 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | MA050722 |
Business Practice Address: | 340 Montage Mountain Rd Moosic, PA - 185071782 |
Business Phone Number: | 5703449266 |
Business Fax Number: | 5705586838 |
Mailing Address: | 51 Pittston Ave, YATESVILLE |
State: | PA |
Postal Code: | 186403368 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/27/2006 |
NPI Last Update Date: | 09/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA050722 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |