Provider Demographics
NPI:1265968952
Name:PESSIS, MELISSA (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PESSIS
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3454
Mailing Address - Country:US
Mailing Address - Phone:612-578-2287
Mailing Address - Fax:
Practice Address - Street 1:600 CENTRAL AVE STE 333
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5605
Practice Address - Country:US
Practice Address - Phone:847-535-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily