Provider Demographics
NPI:1275923674
Name:THOMAS, MELISSA VERONICA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:VERONICA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:VERONICA
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:1605 DANBURY LN
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-7115
Mailing Address - Country:US
Mailing Address - Phone:256-452-8591
Mailing Address - Fax:
Practice Address - Street 1:1605 DANBURY LN
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-7115
Practice Address - Country:US
Practice Address - Phone:256-452-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-101355163W00000X, 163WH0200X, 163WH1000X, 163WM0705X, 163WP0809X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care