# MELISSA CHANTELAU

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871922013
- **Gender:** F
- **Credential:** MMS, PA-C, LAT/ATC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2255A2300X | Athletic Trainer | RT005244 | PA | — |
| 363AS0400X | Surgical Physician Assistant | MA060458 | PA | Yes |

## Other

- **Enumeration date:** 11/07/2013
- **Last updated:** 05/23/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | MA060458 | STATE LICENSE | PA |