Provider Demographics
NPI:1194198838
Name:PERCY, MELANIE SMITH (RN, PHD, CPNP)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:SMITH
Last Name:PERCY
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Gender:F
Credentials:RN, PHD, CPNP
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Mailing Address - Street 1:66 W GILBERT ST RM 1135
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:843-459-4120
Mailing Address - Fax:973-972-8947
Practice Address - Street 1:274 S ORANGE AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2419
Practice Address - Country:US
Practice Address - Phone:973-732-6040
Practice Address - Fax:862-902-7874
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2021-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00290600363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics