Healthcare Provider Details

I. General information

NPI: 1669712220
Provider Name (Legal Business Name): MELVIN SCOTT CRNP-FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MARYLAND AVE
BALTIMORE MD
21218-5017
US

IV. Provider business mailing address

5804 BALTIMORE AVE
HYATTSVILLE MD
20781
US

V. Phone/Fax

Practice location:
  • Phone: 443-708-4814
  • Fax:
Mailing address:
  • Phone: 301-927-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR186443
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR186443
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: