Provider Demographics
NPI:1407277833
Name:ALEGRE-GUZMAN, MELISSA H (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:H
Last Name:ALEGRE-GUZMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4791 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5324
Mailing Address - Country:US
Mailing Address - Phone:770-422-1400
Mailing Address - Fax:
Practice Address - Street 1:92 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1263
Practice Address - Country:US
Practice Address - Phone:201-342-0066
Practice Address - Fax:201-342-0079
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN257239363L00000X, 363LA2200X
NJ26NJ00476200363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care