Provider Demographics
NPI:1780157396
Name:PIERCE, MELISSA ANN (AANP-FNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:AANP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-7861
Mailing Address - Country:US
Mailing Address - Phone:580-286-2299
Mailing Address - Fax:888-355-6329
Practice Address - Street 1:2103 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-7861
Practice Address - Country:US
Practice Address - Phone:580-286-2299
Practice Address - Fax:888-355-6329
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily