Healthcare Provider Details

I. General information

NPI: 1811806540
Provider Name (Legal Business Name): MELISSA GARNETT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 16TH AVE SW
NEW BRIGHTON MN
55112-3320
US

IV. Provider business mailing address

352 16TH AVE SW
NEW BRIGHTON MN
55112-3320
US

V. Phone/Fax

Practice location:
  • Phone: 949-456-3102
  • Fax:
Mailing address:
  • Phone: 949-456-3102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number2310051
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: