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NPI Code Detail

MEDICARE: MELISSA SUE ANDERSON PA-C

MEDICARE: MELISSA SUE ANDERSON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA001242ME
2363A00000XPhysician AssistantPA60229706WA
3363A00000XPhysician Assistant1144521170MI

General Provider Information

NPI Number : 1144521170
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA SUE ANDERSON PA-C
Provider Business Mailing Address
First Line : PO BOX 427
Second Line :
City : HILLMAN
State : MI
Zip : 49746-0427
Country : US
Telephone Number : 989-354-2197
Fax Number : 989-354-1952
Provider Business Practice Location Address
First Line : 15774 STATE ST
Second Line :
City : HILLMAN
State : MI
Zip : 49746-7961
Country : US
Telephone Number : 989-742-4583
Fax Number : 989-742-2183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2010
Last Update Date : 02/01/2017

Similar Medicare Providers

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Practice Location Address:
15774 STATE ST
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1164445524 — CECILIA PEASLEY CFNP
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1497967202 — TIMOTHY LEE HAYES D.O.
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1386077980 — TRISHA JANE DESCHAMPS FNP
Practice Location Address:
15774 STATE ST
HILLMAN, MI
49746-7961
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Practice Fax: 989-742-2183
1497171607 — ERIN FLETCHER MSW
Practice Location Address:
15774 STATE ST
HILLMAN, MI
49746-7961
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1992106702 — MARY JAMESON MSW
Practice Location Address:
15774 STATE ST
HILLMAN, MI
49746-7961
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Practice Fax: 989-742-2183

Directions to “ MELISSA SUE ANDERSON PA-C” Practice Location

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