Provider Demographics
NPI:1174619472
Name:OIKLE, MELISSA JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:OIKLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-2709
Practice Address - Street 1:100 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NORTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01534-1415
Practice Address - Country:US
Practice Address - Phone:508-528-2700
Practice Address - Fax:508-528-5759
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1526363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA67870OtherFALLON HEALTH PLAN
AP1884Medicare ID - Type Unspecified
MA67870OtherFALLON HEALTH PLAN