Bouassaba, Melissa Renee

Bouassaba, Melissa Renee is an individual health care provider with primary practice located at 890 W Faris Rd Ste 580 , Greenville SC 29605-4281. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bouassaba, Melissa Renee can be contacted via phone (864) 455-7874.

Contact Information

Primary practice address
890 W Faris Rd Ste 580 Greenville SC 29605-4281
Phone: (864) 455-7874
Fax: (864) 455-8933
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 23210 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 209009613 Illinois

Profile Details

NPI number 1922362052
LBN Legal business name Bouassaba, Melissa Renee
Credentials BC-ACNS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2012
Last updated May 14th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922362052 NPPES
South Carolina MEDICAID NP6225

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