Provider Demographics
NPI:1144562778
Name:BRYSON, MELISSA PENSMITH (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:PENSMITH
Last Name:BRYSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 KNOX ABBOTT DR
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-3340
Mailing Address - Country:US
Mailing Address - Phone:803-939-8400
Mailing Address - Fax:
Practice Address - Street 1:700 KNOX ABBOTT DR
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-3340
Practice Address - Country:US
Practice Address - Phone:803-939-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC70214163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health