Provider Demographics
NPI:1457937427
Name:NICHOLSON, MELISSA ANN
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2788
Mailing Address - Country:US
Mailing Address - Phone:724-834-1144
Mailing Address - Fax:
Practice Address - Street 1:1037 COMPASS CIR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2788
Practice Address - Country:US
Practice Address - Phone:724-834-1144
Practice Address - Fax:724-552-2086
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN312902164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse