Healthcare Provider Details

I. General information

NPI: 1356252506
Provider Name (Legal Business Name): MELISSA BRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

909 WILSON RD
EAST LANSING MI
48824-6410
US

IV. Provider business mailing address

2745 BRETBY DR
TROY MI
48098-2107
US

V. Phone/Fax

Practice location:
  • Phone: 517-881-2871
  • Fax:
Mailing address:
  • Phone: 248-729-3473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: