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NPI 1316703606

NPI 1316703606 : MELISSA FRUCCI : CHERRY HILL, NJ

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General NPI Number Information
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    NPI Number           |    1316703606
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA FRUCCI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/23/2024
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    Last Update Date     |    08/01/2025
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Provider Practice Location Address
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    Address Line         |    1 BRACE RD STE H 
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    City                 |    CHERRY HILL
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    State                |    NJ
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    Zip                  |    08034-2600
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    Country              |    US
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    Telephone            |    856-547-0389
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    301 LIPPINCOTT DR STE 410 
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    City                 |    MARLTON
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    State                |    NJ
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    Zip                  |    08053-4197
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    Country              |    US
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    Telephone            |    856-355-0340
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WC0200X
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    Taxonomy Name        |    Critical Care Medicine Registered Nurse
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    License Number       |    26NR10667600
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    License Number State |    NJ
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Taxonomy #2
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    Taxonomy Code        |    363LA2100X
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    Taxonomy Name        |    Acute Care Nurse Practitioner
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    License Number       |    26NJ15030800
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    License Number State |    NJ
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