Provider Demographics
NPI:1821365735
Name:CHRISTIAN, MELISHA DAWN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISHA
Middle Name:DAWN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 HIDDEN ACRES CT
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-6765
Mailing Address - Country:US
Mailing Address - Phone:423-288-8443
Mailing Address - Fax:
Practice Address - Street 1:807 UNIVERSITY PKWY
Practice Address - Street 2:BOX 70267
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37614-6500
Practice Address - Country:US
Practice Address - Phone:423-439-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000016254363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily