Provider Demographics
NPI:1780022517
Name:MELSON, BRIANNA SHANNON (NP)
Entity type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:SHANNON
Last Name:MELSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:SHANNON
Other - Last Name:JANCSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 HIGHLAND AVENUE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-745-4489
Mailing Address - Fax:978-741-3131
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:MEDICAL OFFICE BLDG SUITE 316
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-741-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2281354163W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse