Healthcare Provider Details

I. General information

NPI: 1528264314
Provider Name (Legal Business Name): MELISSA A SAXON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA FITZGERALD SAXON

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 04/27/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N FANT ST
ANDERSON SC
29621-5708
US

IV. Provider business mailing address

PO BOX 262
ANDERSON SC
29622-0262
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-3900
  • Fax:
Mailing address:
  • Phone: 864-512-2425
  • Fax: 864-512-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3253
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3253
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: