Provider Demographics
NPI:1215032230
Name:HALL, MELISSA LEANN (NP-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEANN
Last Name:HALL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2372 LIFESTYLE WAY
Mailing Address - Street 2:STE 152
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4940
Mailing Address - Country:US
Mailing Address - Phone:706-937-6099
Mailing Address - Fax:
Practice Address - Street 1:4355 HIGHWAY 58 STE 101
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-2941
Practice Address - Country:US
Practice Address - Phone:423-892-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily