Healthcare Provider Details

I. General information

NPI: 1831648260
Provider Name (Legal Business Name): MELISSA ESSIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 HOGBACK RD STE 5A
ANN ARBOR MI
48105-9750
US

IV. Provider business mailing address

22934 GLENBROOK ST
SAINT CLAIR SHORES MI
48082-1138
US

V. Phone/Fax

Practice location:
  • Phone: 734-263-2417
  • Fax:
Mailing address:
  • Phone: 248-894-1380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704273832
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704273832
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: