Healthcare Provider Details

I. General information

NPI: 1184778821
Provider Name (Legal Business Name): MELISSA MARIE NURRE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W 3RD AVE
ALBANY GA
31701-1943
US

IV. Provider business mailing address

7449 WHITEHALL DR
DAYTON OH
45459-3444
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-1000
  • Fax:
Mailing address:
  • Phone: 513-205-8635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberCOA.05635-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: