Doctor Name: | MRS. MELISSA ANN PIXLEY |
NPI Number: | 1114318391 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 209012576 |
Business Practice Address: | 400 Riverside Dr Ste 2100 Bourbonnais, IL - 609145004 |
Business Phone Number: | 8159352784 |
Business Fax Number: | 8159355687 |
Mailing Address: | 400 Riverside Dr Ste 2100, BOURBONNAIS |
State: | IL |
Postal Code: | 609145004 |
Phone Number: | 8159352784 |
Fax Number: | 8159355687 |
NPI Enumeration Date: | 02/10/2015 |
NPI Last Update Date: | 02/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209012576 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |