Provider Demographics
NPI:1750346003
Name:WILLIAMS, MELISSA DIANE (CNNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:DIANE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:902 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2724
Mailing Address - Country:US
Mailing Address - Phone:423-664-4460
Mailing Address - Fax:423-648-5675
Practice Address - Street 1:975 E 3RD ST
Practice Address - Street 2:BOX 159
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2103
Practice Address - Country:US
Practice Address - Phone:423-778-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000063049163WN0002X
TNAPN0000010867363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care