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General NPI Number Information
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NPI Number | 1588164560
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Entity Type | Individual
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Provider Name | MELISSA ANNE MERTZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 41837 SIERRA DRIVE
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City | THREE RIVERS
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State | CA
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Zip | 93271
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Country | US
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Telephone | 559-462-5030
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Fax | 559-245-0091
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Provider Business Mailing Address
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Address Line | 44778 MINERAL KING RD
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City | THREE RIVERS
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State | CA
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Zip | 93271-9712
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Country | US
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Telephone | 310-923-4392
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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 | 95008400
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License Number State | CA
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