Individual
MELISSA F SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
66 OLD AIRPORT RD, HATTIESBURG, MS 39401-8382
(601) 544-7500
(601) 544-7524
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-0231
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
803904
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R803904
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02070024
—
MS
01
—
P00323873
RR MCARE W PARADIGM
MS
Enumeration date
05/26/2006
Last updated
06/23/2020
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