Healthcare Provider Details

I. General information

NPI: 1952178386
Provider Name (Legal Business Name): MELISSA JEAN PRICE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6617 HOES HILL RD
CONESUS NY
14435-9530
US

IV. Provider business mailing address

6617 HOES HILL RD
CONESUS NY
14435-9530
US

V. Phone/Fax

Practice location:
  • Phone: 585-662-8159
  • Fax:
Mailing address:
  • Phone: 585-662-8159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number687618-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: