Provider Demographics
NPI:1982955969
Name:SMITH, MELISSA CHRISTINE (RN BC PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:CHRISTINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN BC PMHNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:655 SOUTH 7TH STREET BLDG 700/700-A
Mailing Address - Street 2:78 MDG/SGOW
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098
Mailing Address - Country:US
Mailing Address - Phone:478-327-8398
Mailing Address - Fax:478-327-8400
Practice Address - Street 1:215 BENJAMIN AVE
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31098-1062
Practice Address - Country:US
Practice Address - Phone:618-795-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX530776363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health