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General NPI Number Information
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NPI Number | 1093164725
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Entity Type | Individual
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Provider Name | MELISSA BRYSON F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 601 DR MARTIN LUTHER KING JR AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-3619
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Country | US
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Telephone | 505-727-8360
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8603
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340643
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26022
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 63520
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5012551
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License Number State | NC
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