Provider Demographics
NPI:1417196734
Name:HORMANN, MELISSA JOAN (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOAN
Last Name:HORMANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-6178
Mailing Address - Country:US
Mailing Address - Phone:530-321-1287
Mailing Address - Fax:
Practice Address - Street 1:2639 FOREST AVE STE 110
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4393
Practice Address - Country:US
Practice Address - Phone:530-899-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577272163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health