Healthcare Provider Details

I. General information

NPI: 1174893101
Provider Name (Legal Business Name): EDUKE ROLINE MELLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 LENFANT SQ SE
WASHINGTON DC
20020-6724
US

IV. Provider business mailing address

1301 LENFANT SQ SE
WASHINGTON DC
20020-6724
US

V. Phone/Fax

Practice location:
  • Phone: 240-898-6226
  • Fax:
Mailing address:
  • Phone: 240-898-6226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR229690
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN1046368
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1046368
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: