Provider Demographics
NPI:1396070850
Name:SIRLEAF, MELISSA N (PA-C)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:N
Last Name:SIRLEAF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E RUNDBERG LN STE B1
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4860
Mailing Address - Country:US
Mailing Address - Phone:954-253-9611
Mailing Address - Fax:
Practice Address - Street 1:825 E RUNDBERG LN STE B1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4860
Practice Address - Country:US
Practice Address - Phone:954-253-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16241363AM0700X
FLPA9104354363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical