Provider Demographics
NPI:1245001684
Name:ROBERTS, MELISSA BRITTON (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BRITTON
Last Name:ROBERTS
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8261 REVADO HILLS CT
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9167
Mailing Address - Country:US
Mailing Address - Phone:616-916-3046
Mailing Address - Fax:
Practice Address - Street 1:8261 REVADO HILLS CT
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9167
Practice Address - Country:US
Practice Address - Phone:616-916-3046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704280174363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health