Provider Demographics
NPI:1982405502
Name:SUTTON, MELISSA ANN (BSN RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:SUTTON
Suffix:
Gender:
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 823
Mailing Address - Street 2:
Mailing Address - City:KILA
Mailing Address - State:MT
Mailing Address - Zip Code:59920-0823
Mailing Address - Country:US
Mailing Address - Phone:406-407-5987
Mailing Address - Fax:
Practice Address - Street 1:9705 LOST PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MT
Practice Address - Zip Code:59925-9844
Practice Address - Country:US
Practice Address - Phone:406-407-5987
Practice Address - Fax:480-646-3513
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-45743163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent