Provider Demographics
NPI:1306199237
Name:PEOPLES, MELISSA LADONNA (LPN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LADONNA
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 HARVARD PL
Mailing Address - Street 2:LOWER
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1310
Mailing Address - Country:US
Mailing Address - Phone:716-880-9980
Mailing Address - Fax:
Practice Address - Street 1:37 HARVARD PL
Practice Address - Street 2:LOWER
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1310
Practice Address - Country:US
Practice Address - Phone:716-880-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299441164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse