Provider Demographics
NPI:1487861431
Name:MCPHERSON, MALISSA Z (BS)
Entity Type:Individual
Prefix:MS
First Name:MALISSA
Middle Name:Z
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 MESA DR
Mailing Address - Street 2:APT. C 327
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2845
Mailing Address - Country:US
Mailing Address - Phone:501-353-2823
Mailing Address - Fax:
Practice Address - Street 1:11401 MESA DR
Practice Address - Street 2:APT. C 327
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2845
Practice Address - Country:US
Practice Address - Phone:501-353-2823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist