Provider Demographics
NPI:1467715623
Name:WHITAKER, MELISSA GIDDINGS (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:GIDDINGS
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:GIDDINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1222 MCCURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5825
Mailing Address - Country:US
Mailing Address - Phone:410-371-3576
Mailing Address - Fax:410-788-7339
Practice Address - Street 1:681 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1326
Practice Address - Country:US
Practice Address - Phone:410-729-2200
Practice Address - Fax:410-729-3443
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily