Healthcare Provider Details

I. General information

NPI: 1669722401
Provider Name (Legal Business Name): MELISSA MARIE NIXON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W CEDAR ST
STANDISH MI
48658-9526
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-846-4888
  • Fax:
Mailing address:
  • Phone: 989-345-7000
  • Fax: 989-345-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704245250
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: