Healthcare Provider Details

I. General information

NPI: 1215512223
Provider Name (Legal Business Name): MELISSA TRUELOVE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 DEWEY AVE
ROCHESTER NY
14616-3741
US

IV. Provider business mailing address

105 E POINTE
FAIRPORT NY
14450-9777
US

V. Phone/Fax

Practice location:
  • Phone: 585-747-2660
  • Fax: 585-865-0048
Mailing address:
  • Phone: 315-719-2102
  • Fax: 585-865-0048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number737630
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: