Basic Information
Provider Information
NPI: 1649205840
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORTON
FirstName: MELISSA
MiddleName: MILLSAP
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
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OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1984 PEACHTREE RD NW
Address2: STE 515
City: ATLANTA
State: GA
PostalCode: 303095219
CountryCode: US
TelephoneNumber: 4043511754
FaxNumber: 4043517121
Practice Location
Address1: 1640 AIRPORT RD NW
Address2: STE 110
City: KENNESAW
State: GA
PostalCode: 301447038
CountryCode: US
TelephoneNumber: 6782022074
FaxNumber: 7705901442
Other Information
ProviderEnumerationDate: 07/12/2006
LastUpdateDate: 01/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X978978GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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