Provider Demographics
NPI:1548664881
Name:MILLER, MELISSA WINGARD (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:WINGARD
Last Name:MILLER
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:145 HOSPITAL AVE
Mailing Address - Street 2:MEDICAL ARTS BUILDING, SUITE 101
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1462
Mailing Address - Country:US
Mailing Address - Phone:814-375-4089
Mailing Address - Fax:814-375-4967
Practice Address - Street 1:145 HOSPITAL AVE
Practice Address - Street 2:MEDICAL ARTS BUILDING, SUITE 101
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1462
Practice Address - Country:US
Practice Address - Phone:814-375-4089
Practice Address - Fax:814-375-4967
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2014-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP014319363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner