Provider Demographics
NPI:1336304286
Name:MAGNESS, MELISSA JOY (PHD, APRN-BC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOY
Last Name:MAGNESS
Suffix:
Gender:F
Credentials:PHD, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3443 DICKERSON PIKE
Mailing Address - Street 2:STE 680
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2537
Mailing Address - Country:US
Mailing Address - Phone:615-579-7832
Mailing Address - Fax:615-579-7832
Practice Address - Street 1:505 APPLESEED CT
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4891
Practice Address - Country:US
Practice Address - Phone:615-579-7832
Practice Address - Fax:615-579-7832
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN7781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily