Healthcare Provider Details

I. General information

NPI: 1790874279
Provider Name (Legal Business Name): MELISSA SUMNEY ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 LOCUST AVE
WASHINGTON PA
15301-3329
US

IV. Provider business mailing address

400 LOCUST AVE
WASHINGTON PA
15301-3329
US

V. Phone/Fax

Practice location:
  • Phone: 724-222-2577
  • Fax: 724-228-5849
Mailing address:
  • Phone: 724-222-2577
  • Fax: 724-228-5849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN95033
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP009192
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberSP009192
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: