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General NPI Number Information
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NPI Number | 1306142609
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Entity Type | Individual
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Provider Name | MELISSA A. MUNNA APRN
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Gender | Female
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 11975 MORRIS RD STE 140
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City | ALPHARETTA
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State | GA
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Zip | 30005-4444
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Country | US
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Telephone | 678-665-8570
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Fax | 678-205-9005
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Provider Business Mailing Address
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Address Line | 5263 DEERING TRL
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City | MARIETTA
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State | GA
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Zip | 30068-1711
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Country | US
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Telephone | 678-665-8570
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Fax | 678-205-9005
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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 | 00015172
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License Number State | AL
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