Provider Demographics
NPI:1760956536
Name:BURGESS, MELANIE ANNE (CNP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANNE
Last Name:BURGESS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2062
Mailing Address - Country:US
Mailing Address - Phone:978-683-1974
Mailing Address - Fax:978-689-9710
Practice Address - Street 1:413 BROADWAY
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2062
Practice Address - Country:US
Practice Address - Phone:978-683-1974
Practice Address - Fax:978-689-9710
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2260611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily