Provider Demographics
NPI:1437740057
Name:MECHER, MELISSA MAE (APRN, PNP-PC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAE
Last Name:MECHER
Suffix:
Gender:F
Credentials:APRN, PNP-PC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MAE
Other - Last Name:KRUCKEBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:490 BILL KENNEDY WAY SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-6835
Mailing Address - Country:US
Mailing Address - Phone:404-446-4726
Mailing Address - Fax:
Practice Address - Street 1:705 TOWN BLVD NE STE S560
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-7217
Practice Address - Country:US
Practice Address - Phone:404-446-4726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN247462363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics