Provider Demographics
NPI:1316338874
Name:ABBOTT, MELISSA D (NP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:D
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:208 FAIR ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-4338
Mailing Address - Country:US
Mailing Address - Phone:832-477-4348
Mailing Address - Fax:
Practice Address - Street 1:1501 W CHURCH ST STE 800
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-0056
Practice Address - Country:US
Practice Address - Phone:936-327-0191
Practice Address - Fax:713-487-4072
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP127292363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner