Provider Demographics
NPI:1346576543
Name:WHEELES, MELISSA ROGERS (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ROGERS
Last Name:WHEELES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 PHILMORE CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-0260
Mailing Address - Country:US
Mailing Address - Phone:334-887-3902
Mailing Address - Fax:
Practice Address - Street 1:3320 SKYWAY DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-7137
Practice Address - Country:US
Practice Address - Phone:334-826-5577
Practice Address - Fax:334-826-7003
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily