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Individual
MISS MELISSA R DEZAN
Active
Individual
MISS MELISSA R DEZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
726454
NY
164W00000X
Licensed Practical Nurse
3209241
NY
363LF0000X
Family Nurse Practitioner
Primary
350891
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
407997
NY
Other
Enumeration date
02/13/2016
Last updated
04/02/2026
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