Provider Demographics
NPI:1316227762
Name:PAYNE, MELISSA VANDAGRIFF (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:VANDAGRIFF
Last Name:PAYNE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:VANDAGRIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:463 SAM RIDLEY PKWY W
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5626
Mailing Address - Country:US
Mailing Address - Phone:615-768-4258
Mailing Address - Fax:515-768-4259
Practice Address - Street 1:2620 ELM HILL PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3108
Practice Address - Country:US
Practice Address - Phone:615-425-4200
Practice Address - Fax:615-425-4268
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily