Provider Demographics
NPI:1598292930
Name:CEASAR-AMPONSAH, MELANIE DESHAWN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:DESHAWN
Last Name:CEASAR-AMPONSAH
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 1:318 LEISURE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5830
Mailing Address - Country:US
Mailing Address - Phone:281-208-1259
Mailing Address - Fax:
Practice Address - Street 1:318 LEISURE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5830
Practice Address - Country:US
Practice Address - Phone:281-208-1259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133890363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily