MEDICARE: MELANIE CORDORO CRNP

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	363LA2200X	Adult Health Nurse Practitioner	AC000269	MD
2	363LA2200X	Adult Health Nurse Practitioner	0024166805	VA

General Provider Information

NPI Number	:	1679563456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE CORDORO CRNP

Provider Business Mailing Address
First Line	:	8901 WISCONSIN AVE
Second Line	:	BLDG 19, DECK 3, ROOM 3657
City	:	BETHESDA
State	:	MD
Zip	:	20889-5630
Country	:	US
Telephone Number	:	301-319-2112
Fax Number	:	301-295-0981

Provider Business Practice Location Address
First Line	:	8901 WISCONSIN AVE
Second Line	:	BLDG 19, DECK 3, ROOM 3657
City	:	BETHESDA
State	:	MD
Zip	:	20889-5630
Country	:	US
Telephone Number	:	301-319-2112
Fax Number	:	301-295-0981

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	04/19/2016

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