Provider Demographics
NPI:1174060503
Name:PIRANIAN, MELODY ANN (RN, CPNP)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:ANN
Last Name:PIRANIAN
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 SOUTH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1542
Mailing Address - Country:US
Mailing Address - Phone:757-403-3616
Mailing Address - Fax:
Practice Address - Street 1:ANDORRA PEDIATRICS
Practice Address - Street 2:8945 RIDGE AVE ST 5
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19128
Practice Address - Country:US
Practice Address - Phone:215-483-8558
Practice Address - Fax:215-487-1270
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016958363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics