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General NPI Number Information
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NPI Number | 1396561544
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Entity Type | Individual
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Provider Name | MELISA L POWLEY FNP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 102 PARK ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-4403
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Country | US
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Telephone | 518-677-3961
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 COUNTY ROUTE 31
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City | GRANVILLE
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State | NY
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Zip | 12832-4305
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Country | US
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Telephone | 518-538-9573
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2921786
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License Number State | NY
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