Provider Demographics
NPI:1396330296
Name:ANDREASEN, MELISSA LYNNE (NP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNNE
Last Name:ANDREASEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LYNNE
Other - Last Name:ANDREASEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5010
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-5010
Mailing Address - Country:US
Mailing Address - Phone:701-418-8000
Mailing Address - Fax:
Practice Address - Street 1:400 BURDICK EXPY E
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4768
Practice Address - Country:US
Practice Address - Phone:701-857-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR39324363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily