Healthcare Provider Details

I. General information

NPI: 1366488264
Provider Name (Legal Business Name): MELANIE KOEHLER APRN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 SOCKANOSSET CROSS RD STE 305
CRANSTON RI
02920-5559
US

IV. Provider business mailing address

95 SOCKANOSSET CROSS RD STE 305
CRANSTON RI
02920-5559
US

V. Phone/Fax

Practice location:
  • Phone: 401-946-6400
  • Fax: 401-946-6406
Mailing address:
  • Phone: 401-946-6400
  • Fax: 401-946-6406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberAPRN00476
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberPPNS00016
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: