Provider Demographics
NPI:1356734081
Name:GASPAR, MELISSA DAWN (APRN, CNM, FNP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:GASPAR
Suffix:
Gender:F
Credentials:APRN, CNM, FNP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DAWN
Other - Last Name:MCDUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNM
Mailing Address - Street 1:PO BOX 1729
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39403-1729
Mailing Address - Country:US
Mailing Address - Phone:601-545-8700
Mailing Address - Fax:601-255-2645
Practice Address - Street 1:1411 BRADLEY AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:MS
Practice Address - Zip Code:39423-5611
Practice Address - Country:US
Practice Address - Phone:601-784-3922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-04
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906642363LF0000X
MTNUR-APRN-LIC-100052363LF0000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT9903699Medicaid
MT7173621Medicaid