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General NPI Number Information
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NPI Number | 1801197983
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Entity Type | Organization
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Legal Business Name | MELISSA FROST RN A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 415 W CARROLL AVE SUITE 204
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City | GLENDORA
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State | CA
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Zip | 91741-4208
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Country | US
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Telephone | 626-600-8543
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Fax | 626-228-2226
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Provider Business Mailing Address
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Address Line | 415 W CARROLL AVE SUITE 204
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City | GLENDORA
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State | CA
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Zip | 91741-4208
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Country | US
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Telephone | 626-600-8543
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Fax | 626-228-2226
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. MELISSA L FROST
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Credential | NURSE PRACTITIONER
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Telephone | 626-600-8543
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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 | NR491644
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License Number State | CA
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