Provider Demographics
NPI:1023901915
Name:CROSS, MELISSA (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10613 DANUBE DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-6213
Mailing Address - Country:US
Mailing Address - Phone:509-540-7929
Mailing Address - Fax:
Practice Address - Street 1:1129 S 2ND AVE STE B
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4100
Practice Address - Country:US
Practice Address - Phone:509-200-8922
Practice Address - Fax:509-905-2052
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60154735163WA0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)