Provider Demographics
NPI:1538853825
Name:TRIFONE, MELANIE L (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:TRIFONE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23150 LEONARD HALL DR
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-5801
Mailing Address - Country:US
Mailing Address - Phone:240-538-2284
Mailing Address - Fax:
Practice Address - Street 1:23150 LEONARD HALL DR
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-5801
Practice Address - Country:US
Practice Address - Phone:240-538-2284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO97196163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health