Provider Demographics
NPI:1659026854
Name:PRATT, MELISSA KAY (PA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAY
Last Name:PRATT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 COOPER AVE STE 8
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5373
Practice Address - Country:US
Practice Address - Phone:989-752-1177
Practice Address - Fax:989-752-2923
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601010970363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant