Provider Demographics
NPI:1689135733
Name:FROST, MELISSA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:DEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746093
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6093
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:3820 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3227
Practice Address - Country:US
Practice Address - Phone:520-200-6707
Practice Address - Fax:520-300-8052
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ220397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily