Provider Demographics
NPI:1417408113
Name:ASCIONE, MELISSA (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ASCIONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 GOLDSMITH ST
Mailing Address - Street 2:1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3129
Mailing Address - Country:US
Mailing Address - Phone:617-838-8008
Mailing Address - Fax:
Practice Address - Street 1:42 GOLDSMITH ST
Practice Address - Street 2:1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-3129
Practice Address - Country:US
Practice Address - Phone:617-838-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN264634163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse