Provider Demographics
NPI:1912144098
Name:LASSETTER, MELISSA JEAN (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:LASSETTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10627 TWILIGHT CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3527
Mailing Address - Country:US
Mailing Address - Phone:832-603-7188
Mailing Address - Fax:
Practice Address - Street 1:10627 TWILIGHT CREEK LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3527
Practice Address - Country:US
Practice Address - Phone:832-603-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX630139163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics