Provider Demographics
NPI:1164770764
Name:PARRA, MELISSA BOSSARD (DNP, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:BOSSARD
Last Name:PARRA
Suffix:
Gender:F
Credentials:DNP, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8TH AVE & C STREET
Mailing Address - Street 2:E8
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84143
Mailing Address - Country:US
Mailing Address - Phone:801-408-1819
Mailing Address - Fax:801-408-8453
Practice Address - Street 1:8TH AVE & C STREET
Practice Address - Street 2:E8
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84143
Practice Address - Country:US
Practice Address - Phone:801-408-1819
Practice Address - Fax:801-408-8453
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT319170-4405363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care