Provider Demographics
NPI:1003553413
Name:SPIKER, MELODI ANNE X
Entity Type:Individual
Prefix:
First Name:MELODI
Middle Name:ANNE
Last Name:SPIKER
Suffix:X
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3088 CRANBERRY HWY STE A
Mailing Address - Street 2:
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-4800
Mailing Address - Country:US
Mailing Address - Phone:508-295-7990
Mailing Address - Fax:508-295-3117
Practice Address - Street 1:3088 CRANBERRY HWY STE A
Practice Address - Street 2:
Practice Address - City:EAST WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02538-4800
Practice Address - Country:US
Practice Address - Phone:508-295-7790
Practice Address - Fax:508-295-3117
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN170815163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse