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NPI Code Detail

MEDICARE: MELISSA NELSON

MEDICARE: MELISSA NELSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantA3988MD
2225200000XPhysical Therapy AssistantPTA09137OH

General Provider Information

NPI Number : 1023400884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA NELSON
Provider Business Mailing Address
First Line : 2532 CREST VIEW LN
Second Line :
City : CHESAPEAKE BEACH
State : MD
Zip : 20732-4689
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 85 HOSPITAL RD
Second Line :
City : PRINCE FREDERICK
State : MD
Zip : 20678-4018
Country : US
Telephone Number : 410-535-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2015
Last Update Date : 03/03/2015

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