Melinda Sue Mowry, R.N.

Individual provider Active NPI Pediatric Registered Nurse · Le Roy, NY

NPI 1235339706 · NPPES record last updated Jul 23, 2007

Key facts

NPI
1235339706
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Registered Nurse 163WP0200X
License
535598 (NY)
Practice address
8172 Parmalee Rd
Le Roy, NY 14482-9359
Phone
(585) 768-9297
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
535598NYMDPediatric Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 535598 NY Yes

Addresses

Primary practice location

8172 Parmalee Rd
Le Roy, NY 14482-9359

Mailing address

8172 Parmalee Rd
Le Roy, NY 14482-9359

Other identifiers

IdentifierTypeStateIssuer
02632722MedicaidNY

Other providers in Le Roy, NY

All providers in Le Roy, NY · Pediatric Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.