Provider Demographics
NPI:1770803173
Name:CHASON, MELISSA SHARON (FNP)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:SHARON
Last Name:CHASON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:HISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 PEACHTREE INDUSTRIAL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-6288
Mailing Address - Country:US
Mailing Address - Phone:678-765-8622
Mailing Address - Fax:678-765-8621
Practice Address - Street 1:110 PEACHTREE INDUSTRIAL BLVD STE A
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-6288
Practice Address - Country:US
Practice Address - Phone:678-765-8622
Practice Address - Fax:678-765-8621
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN158856363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics