Provider Demographics
NPI:1114668183
Name:ROSE, MELISSA A (AADP, AFMC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:ROSE
Suffix:
Gender:F
Credentials:AADP, AFMC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:INHC
Mailing Address - Street 1:635 LEGEND LOOP APT 301
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-8637
Mailing Address - Country:US
Mailing Address - Phone:406-595-2331
Mailing Address - Fax:
Practice Address - Street 1:201 W MADISON AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3958
Practice Address - Country:US
Practice Address - Phone:406-595-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach