Provider Demographics
NPI:1689453714
Name:DECELLES, MELISSA ANNE (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:DECELLES
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:HEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4758
Mailing Address - Country:US
Mailing Address - Phone:303-930-7803
Mailing Address - Fax:303-930-5503
Practice Address - Street 1:11750 W 2ND PL STE 160
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1724
Practice Address - Country:US
Practice Address - Phone:303-430-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1654419163W00000X
CORXN.0108207-NP363L00000X
COAPN.0999148-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner