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Individual

MS. MELISSA MARTIN BYRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPCP

Contact information

Practice address
19283 HIGHWAY 59, SUMMERDALE, AL 36580-3005
(251) 523-5437
(866) 628-7517
Mailing address
19283 HIGHWAY 59, SUMMERDALE, AL 36580-3005
(251) 523-5437
(866) 628-7517

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-081366
AL
363LP0200X
Pediatric Nurse Practitioner
9200085
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
1063439065
NPI GROUP PAYEE NUMBER
AL
01
1275872780
GROUP NPI
FL
05
305877800
FL
05
630000013
AL
01
9200085
PEDIATRIC NURSING LICENSE
FL
Enumeration date
03/08/2006
Last updated
08/28/2024
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