Provider Demographics
NPI:1518569599
Name:ATTANASIO, MELISSA ANN (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:ATTANASIO
Suffix:
Gender:F
Credentials:MSN, CRNP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:FLOOR 5 RAVDIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4486
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:FLOOR 5 RAVDIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-615-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP022646363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner