Provider Demographics
NPI:1730630344
Name:BRIGGS, MELISSA (CPM, LM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GARY L MAIETTA PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-7816
Mailing Address - Country:US
Mailing Address - Phone:207-358-9801
Mailing Address - Fax:
Practice Address - Street 1:14 GARY L MAIETTA PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-7816
Practice Address - Country:US
Practice Address - Phone:207-358-9801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1057176B00000X
MECPM644176B00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECPM644OtherSTATE