Provider Demographics
NPI:1598844003
Name:LIGGINS, MELISSA LYNN (NNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:LIGGINS
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LYNN
Other - Last Name:CHAMBERLIN (HUBER)
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:300 W CLARENDON AVE STE 375
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3476
Mailing Address - Country:US
Mailing Address - Phone:602-277-4161
Mailing Address - Fax:602-265-2011
Practice Address - Street 1:300 W CLARENDON AVE STE 375
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3476
Practice Address - Country:US
Practice Address - Phone:602-277-4161
Practice Address - Fax:602-265-2011
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP20432363LN0000X
AZAP2522363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ146861Medicaid