Provider Demographics
NPI:1336467273
Name:WHITE, MELISSA JO (CNM)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JO
Last Name:WHITE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 BROADWAY ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-4758
Mailing Address - Country:US
Mailing Address - Phone:713-643-7100
Mailing Address - Fax:713-643-3592
Practice Address - Street 1:3933 BROADWAY ST
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4758
Practice Address - Country:US
Practice Address - Phone:713-643-7100
Practice Address - Fax:713-643-3592
Is Sole Proprietor?:No
Enumeration Date:2010-05-16
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife