Provider Demographics
NPI:1538442835
Name:BERRY, MELISSIA A (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:MELISSIA
Middle Name:A
Last Name:BERRY
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:MELISSIA
Other - Middle Name:A
Other - Last Name:SEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3030 NORTH ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1433
Mailing Address - Country:US
Mailing Address - Phone:409-832-9600
Mailing Address - Fax:409-832-9610
Practice Address - Street 1:3030 NORTH ST
Practice Address - Street 2:SUITE 450
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1433
Practice Address - Country:US
Practice Address - Phone:409-832-9600
Practice Address - Fax:409-832-9610
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX641157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily