Provider Demographics
NPI:1811361496
Name:FLEENER, MELISSA LYNN (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:FLEENER
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 KEMP BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-5419
Mailing Address - Country:US
Mailing Address - Phone:940-692-1220
Mailing Address - Fax:940-689-5094
Practice Address - Street 1:4301 WILSON ST
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-4472
Practice Address - Country:US
Practice Address - Phone:580-558-8283
Practice Address - Fax:580-558-3303
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK82468363LP0808X
TXAP126371363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health