Provider Demographics
NPI:1528721883
Name:MELANSON, TERESSA P (NP)
Entity type:Individual
Prefix:
First Name:TERESSA
Middle Name:P
Last Name:MELANSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5814
Mailing Address - Country:US
Mailing Address - Phone:603-834-8444
Mailing Address - Fax:
Practice Address - Street 1:127 LONG SANDS RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1158
Practice Address - Country:US
Practice Address - Phone:207-363-7430
Practice Address - Fax:207-363-9864
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP211431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily