Provider Demographics
NPI:1386093748
Name:CUTILLO, MELANIE (CRNP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CUTILLO
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 1:504 COURTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9220
Mailing Address - Country:US
Mailing Address - Phone:610-639-2348
Mailing Address - Fax:
Practice Address - Street 1:504 COURTSIDE AVE
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9220
Practice Address - Country:US
Practice Address - Phone:610-639-2348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016184363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care