Individual
MELISSA M BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
527 MEDICAL PARK DR STE 205, BRIDGEPORT, WV 26330-9009
(681) 342-3730
Mailing address
100 TWIN PONDS LN, MORGANTOWN, WV 26508-4878
(985) 804-1770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
88110
WV
363L00000X
Nurse Practitioner
Primary
105067
WV
Other
Enumeration date
01/18/2020
Last updated
04/15/2022
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