Provider Demographics
NPI:1528048824
Name:PAIRO, MELODY MALEAR (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:MALEAR
Last Name:PAIRO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 S DIVISION ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-7021
Mailing Address - Country:US
Mailing Address - Phone:410-749-2599
Mailing Address - Fax:
Practice Address - Street 1:1346 S DIVISION ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-7021
Practice Address - Country:US
Practice Address - Phone:410-749-2599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR075856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD543306100Medicaid
MD543306100Medicaid
MD917MJ090Medicare ID - Type Unspecified