Individual
MELISSA ANN LISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 AVENUE F, BAY CITY, TX 77414-4117
(979) 245-2008
(979) 245-2205
Mailing address
101 AVENUE F N, BAY CITY, TX 77414-3167
(979) 245-2008
(979) 245-0744
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
651257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12706093
CAQH
—
05
—
357226501
—
TX
01
—
4816948
AETNA HEALTH INSURANCE
—
01
—
HO8783NC01
BCBS OF TX
TX
Enumeration date
06/11/2013
Last updated
01/05/2022
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