Healthcare Provider Details

I. General information

NPI: 1790756807
Provider Name (Legal Business Name): DORIS JEANNETTE MELENDEZ-WARREN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

13916 OVERTON LN
SILVER SPRING MD
20904-1129
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-3806
  • Fax:
Mailing address:
  • Phone: 301-879-0053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRO95142
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: