Healthcare Provider Details

I. General information

NPI: 1275437691
Provider Name (Legal Business Name): MELISSA ANNE NELSON APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 S HIGLEY RD STE 104
GILBERT AZ
85296-5045
US

IV. Provider business mailing address

1525 S HIGLEY RD STE 104
GILBERT AZ
85296-5045
US

V. Phone/Fax

Practice location:
  • Phone: 480-901-4227
  • Fax:
Mailing address:
  • Phone: 480-901-4227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number345992
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: