MEDICARE: MS. FRANCESCA T MELLE PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA169805	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50052712	OTHER	PA	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1063471852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRANCESCA T MELLE PAC

Provider Business Mailing Address
First Line	:	150 SW ARROW
Second Line	:
City	:	WALDPORT
State	:	OR
Zip	:	97394
Country	:	US
Telephone Number	:	541-536-3197
Fax Number	:	541-536-3198

Provider Business Practice Location Address
First Line	:	150 SW ARROW
Second Line	:
City	:	WALDPORT
State	:	OR
Zip	:	97394
Country	:	US
Telephone Number	:	541-536-3197
Fax Number	:	541-536-3198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	03/19/2015

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