Doctor Name: | MELISSA C DODSON |
NPI Number: | 1770568230 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R716928 |
Business Practice Address: | 2 Hardy Rd Mississippi State, MS - 39762 |
Business Phone Number: | 6623252431 |
Business Fax Number: | 6623258888 |
Mailing Address: | Po Box 6338, MISSISSIPPI STATE |
State: | MS |
Postal Code: | 39762 |
Phone Number: | 6623252431 |
Fax Number: | 6623258888 |
NPI Enumeration Date: | 12/07/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R716928 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |