Provider Demographics
NPI:1295191120
Name:BROWN, MELESSA DENEE (CERTHAIRLOSS SPEC)
Entity Type:Individual
Prefix:
First Name:MELESSA
Middle Name:DENEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CERTHAIRLOSS SPEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1166
Mailing Address - Country:US
Mailing Address - Phone:302-602-0507
Mailing Address - Fax:
Practice Address - Street 1:731 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1166
Practice Address - Country:US
Practice Address - Phone:302-602-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEM1-01000101744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management