Provider Demographics
NPI:1558505529
Name:NEVILLE-NORTON, MELISSA ANN (DNP, APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:NEVILLE-NORTON
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:NEVILLE-SWENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3875 STADIUM WAY # 3903 WEBER STATE UNIVERSITY
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84408
Mailing Address - Country:US
Mailing Address - Phone:801-626-6204
Mailing Address - Fax:
Practice Address - Street 1:3875 STADIUM WAY # 3903 WEBER STATE UNIVERSITY
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84408
Practice Address - Country:US
Practice Address - Phone:801-626-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2019-10-15
Deactivation Date:2010-03-02
Deactivation Code:
Reactivation Date:2019-10-14
Provider Licenses
StateLicense IDTaxonomies
UT3647144405363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics