Healthcare Provider Details

I. General information

NPI: 1992348395
Provider Name (Legal Business Name): MELANIE MCKINSTRY MORRISON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2019
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 DUTCH FORK RD
CHAPIN SC
29036-7576
US

IV. Provider business mailing address

407 LIFESPRINGS CT
SIMPSONVILLE SC
29681-6904
US

V. Phone/Fax

Practice location:
  • Phone: 910-742-9243
  • Fax: 888-746-1787
Mailing address:
  • Phone: 864-684-2381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number230436
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number23380
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: