Provider Demographics
NPI:1275294878
Name:MELISSA WHITMIRE NP PLLC
Entity Type:Organization
Organization Name:MELISSA WHITMIRE NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, FNP-C
Authorized Official - Phone:254-482-1013
Mailing Address - Street 1:6335 COUNTY ROAD 328
Mailing Address - Street 2:
Mailing Address - City:MILANO
Mailing Address - State:TX
Mailing Address - Zip Code:76556-2972
Mailing Address - Country:US
Mailing Address - Phone:254-482-1013
Mailing Address - Fax:
Practice Address - Street 1:1904 BRAZOS AVE
Practice Address - Street 2:
Practice Address - City:ROCKDALE
Practice Address - State:TX
Practice Address - Zip Code:76567-2518
Practice Address - Country:US
Practice Address - Phone:254-482-1013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty