Provider Demographics
NPI:1215624002
Name:FERRELL, MELISSA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FERRELL
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21640 N 19TH AVE STE C101
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2735
Mailing Address - Country:US
Mailing Address - Phone:602-851-8227
Mailing Address - Fax:602-851-8229
Practice Address - Street 1:21640 N 19TH AVE STE C101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2735
Practice Address - Country:US
Practice Address - Phone:602-851-8227
Practice Address - Fax:602-851-8229
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ290777363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health