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General NPI Number Information
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NPI Number | 1811660756
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Entity Type | Individual
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Provider Name | HERMELLA M MELESE
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Gender | Female
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Dates
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Enumeration Date | 07/27/2021
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 43402 APPLE ORCHARD SQ
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City | ASHBURN
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State | VA
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Zip | 20148-7581
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Country | US
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Telephone | 571-619-0184
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Fax | 804-800-4117
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Provider Business Mailing Address
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Address Line | PO BOX 2593
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City | MANASSAS
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State | VA
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Zip | 20108-0865
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Country | US
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Telephone | 571-619-0184
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Fax | 804-800-4117
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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 | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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