Provider Demographics
NPI:1912579962
Name:MELISSA RAMSEY CRNP
Entity Type:Organization
Organization Name:MELISSA RAMSEY CRNP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-852-1611
Mailing Address - Street 1:3169 BRAVERTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2690
Mailing Address - Country:US
Mailing Address - Phone:443-852-1611
Mailing Address - Fax:301-808-3154
Practice Address - Street 1:3169 BRAVERTON ST STE 200
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2690
Practice Address - Country:US
Practice Address - Phone:443-852-1611
Practice Address - Fax:301-808-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD520116100Medicaid