Provider Demographics
NPI:1932785946
Name:GOWER, MELISSA CHANEY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:CHANEY
Last Name:GOWER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 JEFFERSON ST NW APT 424
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5034
Mailing Address - Country:US
Mailing Address - Phone:256-527-0272
Mailing Address - Fax:
Practice Address - Street 1:2780 BOB WALLACE AVE SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-4104
Practice Address - Country:US
Practice Address - Phone:256-533-4626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-20
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-166682363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care