Provider Demographics
NPI:1932836202
Name:NELSON, MELISSA RENEE (LVN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENEE
Last Name:NELSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 COHASSET RD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2212
Mailing Address - Country:US
Mailing Address - Phone:916-642-7800
Mailing Address - Fax:530-399-0242
Practice Address - Street 1:556 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2212
Practice Address - Country:US
Practice Address - Phone:916-642-7800
Practice Address - Fax:530-399-0242
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA189466164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse