Provider Demographics
NPI:1275386591
Name:ANDERSON, MELANIE WATSON (RN)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:WATSON
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2241
Mailing Address - Country:US
Mailing Address - Phone:205-420-8361
Mailing Address - Fax:
Practice Address - Street 1:2521 WALDRIDGE RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-6837
Practice Address - Country:US
Practice Address - Phone:205-402-5139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-104065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse