Healthcare Provider Details

I. General information

NPI: 1750943056
Provider Name (Legal Business Name): MELORIE Y FIELDS RN, MSN-M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

IV. Provider business mailing address

11160 VEIRS MILL RD # LLH18297
WHEATON MD
20902-2538
US

V. Phone/Fax

Practice location:
  • Phone: 202-537-4000
  • Fax:
Mailing address:
  • Phone: 910-364-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number250069
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: