Healthcare Provider Details

I. General information

NPI: 1568832400
Provider Name (Legal Business Name): MELONY AVELLA-HOWELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELONY BEATSON NP

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 AURORA CT MAIL STOP F-704
AURORA CO
80045-2517
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-3872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0993393-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172951
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: