Provider Demographics
NPI:1740078468
Name:ANDERSON, MELISSA HARRIS (NNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:HARRIS
Last Name:ANDERSON
Suffix:
Gender:
Credentials:NNP
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:HARRIS
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6126 OLDE FIELDS WAY
Mailing Address - Street 2:
Mailing Address - City:PFAFFTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27040-8222
Mailing Address - Country:US
Mailing Address - Phone:336-403-4473
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-713-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5022069363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care