Provider Demographics
NPI:1952960114
Name:KEISER, MELISSA MARIE (PEDIATRIC NURSE PRAC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MARIE
Last Name:KEISER
Suffix:
Gender:F
Credentials:PEDIATRIC NURSE PRAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ROUTE 28
Mailing Address - Street 2:SUITE 2205
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869
Mailing Address - Country:US
Mailing Address - Phone:908-725-5530
Mailing Address - Fax:908-253-6559
Practice Address - Street 1:575 ROUTE 28
Practice Address - Street 2:SUITE 2100
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869
Practice Address - Country:US
Practice Address - Phone:908-725-5530
Practice Address - Fax:908-253-6559
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NR20707300163WP0200X
NJ26NJ00936300363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics