Provider Demographics
NPI:1457750937
Name:GULDEN- MALESON, MELISSA ANN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:GULDEN- MALESON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:GULDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC / CNP
Mailing Address - Street 1:1650 NEW BRIGHTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1643
Mailing Address - Country:US
Mailing Address - Phone:763-447-2506
Mailing Address - Fax:
Practice Address - Street 1:1650 NEW BRIGHTON BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-1643
Practice Address - Country:US
Practice Address - Phone:763-447-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 179581-9363L00000X
MNCNP 1717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner