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General NPI Number Information
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NPI Number | 1366754012
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Entity Type | Individual
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Provider Name | MELISSA ELLIS DAMMANN ACNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 698 FAIRVIEW RD
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6708
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 LAURENS RD
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City | GREENVILLE
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State | SC
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Zip | 29607-3224
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Country | US
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Telephone | 864-288-8280
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5009361
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | COA11531
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License Number State | OH
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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 | 24199
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APN.24199
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.24199
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License Number State | SC
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