Healthcare Provider Details

I. General information

NPI: 1760608343
Provider Name (Legal Business Name): SHARIEVE MELLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 WEST MOUNT PLEASANT AVENUE SUITE 107
LIVINGSTON NJ
07039
US

IV. Provider business mailing address

513 WEST MOUNT PLEASANT AVENUE SUITE 107
LIVINGSTON NJ
07039
US

V. Phone/Fax

Practice location:
  • Phone: 973-533-1195
  • Fax: 973-533-1305
Mailing address:
  • Phone: 973-533-1195
  • Fax: 973-533-1305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number26NC07158300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: