Healthcare Provider Details

I. General information

NPI: 1861864159
Provider Name (Legal Business Name): DANIELLE ANN MELICAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 PENNINGTON RD #204
PENNINGTON NJ
08534-5225
US

IV. Provider business mailing address

54 MARY ST
BORDENTOWN NJ
08505-1812
US

V. Phone/Fax

Practice location:
  • Phone: 609-737-7512
  • Fax:
Mailing address:
  • Phone: 609-440-8859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLK-0010241
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00058600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: