Provider Demographics
NPI:1235914177
Name:WHITE, MELISSA MAY (PMHNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAY
Last Name:WHITE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3607
Mailing Address - Country:US
Mailing Address - Phone:304-234-3500
Mailing Address - Fax:304-845-9977
Practice Address - Street 1:1819 WOOD ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3607
Practice Address - Country:US
Practice Address - Phone:304-234-3500
Practice Address - Fax:304-845-9977
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV117435363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health