Provider Demographics
NPI:1063857126
Name:BAKER, MELISSA RENEE (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:RENEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:RENEE
Other - Last Name:BEGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1802 HARPER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3376
Mailing Address - Country:US
Mailing Address - Phone:304-252-9211
Mailing Address - Fax:304-252-9218
Practice Address - Street 1:1802 HARPER RD STE 102
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3376
Practice Address - Country:US
Practice Address - Phone:304-252-9211
Practice Address - Fax:304-252-9218
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV49204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily