Healthcare Provider Details

I. General information

NPI: 1659491074
Provider Name (Legal Business Name): MELISSA NASER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 WOODLAND AVE
PHILADELPHIA PA
19143-5137
US

IV. Provider business mailing address

432 N 6TH ST
PHILADELPHIA PA
19123-4004
US

V. Phone/Fax

Practice location:
  • Phone: 215-726-9807
  • Fax: 215-726-0424
Mailing address:
  • Phone: 215-925-2400
  • Fax: 215-925-9162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010155
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: