Healthcare Provider Details

I. General information

NPI: 1821925306
Provider Name (Legal Business Name): MELISSA SCILLUFFO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 HIGHWAY 9 E STE 320
LITTLE RIVER SC
29566-8165
US

IV. Provider business mailing address

3472 EVERSHEEN DR
LITTLE RIVER SC
29566-5702
US

V. Phone/Fax

Practice location:
  • Phone: 843-366-3715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: