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General NPI Number Information
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NPI Number | 1427677194
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Entity Type | Organization
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Legal Business Name | MELIORA DIRECT HEALTH LLC
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 10290 S PROGRESS WAY STE 208
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City | PARKER
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State | CO
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Zip | 80134-9056
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Country | US
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Telephone | 303-317-3088
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Fax | 877-268-5001
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Provider Business Mailing Address
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Address Line | 488 PAWLING AVE
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City | TROY
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State | NY
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Zip | 12180-5832
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Country | US
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Telephone | 720-317-9460
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Fax | 877-268-5001
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | MARY S RICCELLI
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Credential | NP
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Telephone | 720-317-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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