Provider Demographics
NPI:1154753929
Name:STUNTZ, MELISSA MANN (NP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MANN
Last Name:STUNTZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1000 E 3RD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2153
Mailing Address - Country:US
Mailing Address - Phone:423-648-9915
Mailing Address - Fax:423-648-9935
Practice Address - Street 1:1000 E 3RD ST STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2153
Practice Address - Country:US
Practice Address - Phone:423-648-9915
Practice Address - Fax:423-648-9935
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000017778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily