Provider Demographics
NPI:1548274764
Name:SHELLEY, MELISSA LENORE (PA)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LENORE
Last Name:SHELLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LENORE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:75 PRINGLE WAY
Mailing Address - Street 2:#401
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1464
Mailing Address - Country:US
Mailing Address - Phone:775-688-8000
Mailing Address - Fax:775-785-5119
Practice Address - Street 1:645 N ARLINGTON AVE STE 555
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4452
Practice Address - Country:US
Practice Address - Phone:775-770-7622
Practice Address - Fax:775-770-3683
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1055363AM0700X
NV363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical