Provider Demographics
NPI:1184042251
Name:ZAMORA, MELISA D (MSN, NP-C)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:D
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 PEMBERTON DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2501
Mailing Address - Country:US
Mailing Address - Phone:443-978-7170
Mailing Address - Fax:
Practice Address - Street 1:1201 PEMBERTON DR STE 2A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2501
Practice Address - Country:US
Practice Address - Phone:443-978-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1184042251OtherNPI