Basic Information
| Provider Information | |||||||||
| NPI: | 1811957715 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PELIKAN | ||||||||
| FirstName: | MELISA | ||||||||
| MiddleName: | |||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 69 SAND PIT RD | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068104004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037482551 | ||||||||
| FaxNumber: | 2037906375 | ||||||||
| Practice Location | |||||||||
| Address1: | 69 SAND PIT RD | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068104004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037482551 | ||||||||
| FaxNumber: | 2037906375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | R52641 | CT | Y | Nursing Service Providers | Registered Nurse |
No ID Information.