Provider Demographics
NPI:1679208458
Name:NISBETT, MELISSA ANN
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:NISBETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4112
Mailing Address - Country:US
Mailing Address - Phone:979-849-2447
Mailing Address - Fax:979-848-8337
Practice Address - Street 1:120 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4112
Practice Address - Country:US
Practice Address - Phone:979-849-2447
Practice Address - Fax:979-848-8337
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758584163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse