MRS. MELISSA RENEE BOUASSABA BC-ACNS NPI 1922362052

NPI Information

NPI: 1922362052
Provider Name: MRS. MELISSA RENEE BOUASSABA, BC-ACNS
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: PRISMA HEALTH UNIVERSITY MEDICAL GROUP

PECOS Registration: Yes

Address:
890 W FARIS RD STE 580
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-7874
Get Directions

MRS. Melissa Renee Bouassaba, BC-ACNS is an adult health clinical nurse specialist in Greenville, SC with 8 years of experience. MRS. Melissa Renee Bouassaba, BC-ACNS NPI is 1922362052. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

890 W FARIS RD STE 580
GREENVILLE, SC
ZIP 29605-281
Phone: (864) 455-7874
Fax: (864) 455-8933

The NPI 1922362052 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/3/2012 and was last updated on 5/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SA2200X	Clinical Nurse Specialist	Adult Health	209009613	ILLINOIS	No
2	364SA2200X	Clinical Nurse Specialist	Adult Health	23210	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP6225	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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