Provider Demographics
NPI:1396043147
Name:CLAXTON, MELISSA LEA (NP-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEA
Last Name:CLAXTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FIRESIDE WAY
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-2019
Mailing Address - Country:US
Mailing Address - Phone:423-718-9396
Mailing Address - Fax:
Practice Address - Street 1:605 GLENWOOD DR STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1130
Practice Address - Country:US
Practice Address - Phone:423-698-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily