Provider Demographics
NPI:1285897215
Name:SOREY, MELISSA E (CRNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:E
Last Name:SOREY
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 1:8 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1805 ROUTE 206 # 111213
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08088-3558
Practice Address - Country:US
Practice Address - Phone:609-261-0240
Practice Address - Fax:609-291-8880
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001923G363LX0001X
NJ26NN04324800363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NR04324800OtherRN LICENSE
PARN207232LOtherREGISTERED NURSE LICENSE