Individual
MELISSA CRISCILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
411 TOWN PARK BLVD, EVANS, GA 30809-3487
(706) 854-2500
(706) 854-2559
Mailing address
5050 FAIRFIELD CT, AIKEN, SC 29801-1006
(803) 215-9490
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
RN180777
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN180777
GA
363LP0222X
Critical Care Pediatric Nurse Practitioner
RN180777
GA
Other
Enumeration date
02/03/2021
Last updated
09/18/2024
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