MEDICARE: MELLISA CORTRIGHT

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	376J00000X	Homemaker		ND

General Provider Information

NPI Number	:	1982467833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELLISA CORTRIGHT

Provider Business Mailing Address
First Line	:	1205 2ND ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2722
Country	:	US
Telephone Number	:	701-799-5326
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 2ND ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2722
Country	:	US
Telephone Number	:	701-799-5326
Fax Number	:

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

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	02/02/2024

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Directions to “ MELLISA CORTRIGHT ” Practice Location

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