Healthcare Provider Details

I. General information

NPI: 1427433457
Provider Name (Legal Business Name): MELISSA BINUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13300 NEW AIRPORT RD STE 103
AUBURN CA
95602-7407
US

IV. Provider business mailing address

13300 NEW AIRPORT RD STE 103
AUBURN CA
95602-7407
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-8780
  • Fax: 530-889-8781
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number701040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: