Provider Demographics
NPI:1679618169
Name:DUBOIS, MELISSA COLLEEN KNIGHT (NP)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:COLLEEN KNIGHT
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:COLLEEN
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:MASS. GENERAL HOSPITAL, ELLISON 735
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-724-7839
Mailing Address - Fax:617-724-4750
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MASS. GENERAL HOSPITAL, ELLISON 735
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-7839
Practice Address - Fax:617-724-4750
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA259036363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care