Provider Demographics
NPI:1285955807
Name:MUHA, MELISSA M (FNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:M
Last Name:MUHA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8782 WOODGATE DR
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13309-5267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8782 WOODGATE DR
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:NY
Practice Address - Zip Code:13309-5267
Practice Address - Country:US
Practice Address - Phone:315-942-5406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28281566A163W00000X
IL209.028204363LF0000X
OHCNP.0033903363LF0000X
IN71014995A363LF0000X
FLAPRN11016501363LF0000X
MI4704404316363LF0000X
WI15703-33363LF0000X
NY336323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse