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General NPI Number Information
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NPI Number | 1912238585
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Entity Type | Individual
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Provider Name | STEPHANIE CLARE MELLOR RN
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Gender | Female
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 1221 CEDAR LANE RD
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City | MIDDLETOWN
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State | DE
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Zip | 19709-9636
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Country | US
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Telephone | 302-449-5878
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Fax | 302-378-5139
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Provider Business Mailing Address
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Address Line | PO BOX 4010 313 SOUTH FIFTH STREET
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City | ODESSA
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State | DE
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Zip | 19730-4010
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Country | US
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Telephone | 302-376-4128
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Fax | 302-378-5139
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | L1-0025967
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License Number State | DE
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