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NPI Code Detail

MEDICARE: MS. MELISSA DEANNE MORISSETTE FNP-C

MEDICARE:  MS. MELISSA DEANNE MORISSETTE  FNP-C
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
1363LF0000XFamily Nurse PractitionerAP9812AZ

General Provider Information

NPI Number : 1730627498
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA DEANNE MORISSETTE FNP-C
Provider Business Mailing Address
First Line : 261 N ROOSEVELT AVE
Second Line :
City : CHANDLER
State : AZ
Zip : 85226-2616
Country : US
Telephone Number : 480-305-2888
Fax Number : 480-305-2889
Provider Business Practice Location Address
First Line : 1157 S CRISMON RD
Second Line :
City : MESA
State : AZ
Zip : 85208-2661
Country : US
Telephone Number : 480-827-5730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2017
Last Update Date : 11/21/2017

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Directions to “ MS. MELISSA DEANNE MORISSETTE FNP-C” Practice Location

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