Healthcare Provider Details

I. General information

NPI: 1659310449
Provider Name (Legal Business Name): MELISSA F SOUZA APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 ROUTE 73 STE B
VOORHEES NJ
08043-9539
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-7230
  • Fax: 856-247-7231
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00109800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: