Healthcare Provider Details

I. General information

NPI: 1649194747
Provider Name (Legal Business Name): MELISSA PARKISON RN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 COLLEGE AVE
ALAMOGORDO NM
88310-4859
US

IV. Provider business mailing address

609 ADAMS AVE
ALAMOGORDO NM
88310-5203
US

V. Phone/Fax

Practice location:
  • Phone: 575-812-6304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number77648
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: