Provider Demographics
NPI:1255652897
Name:DODSON, MELANIE LYNN (RNFA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:LYNN
Last Name:DODSON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12959 BRUCE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-6608
Mailing Address - Country:US
Mailing Address - Phone:936-537-1563
Mailing Address - Fax:936-890-8838
Practice Address - Street 1:12959 BRUCE RD
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77318-6608
Practice Address - Country:US
Practice Address - Phone:936-537-1563
Practice Address - Fax:936-890-8838
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX630605163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant