Provider Demographics
NPI:1346768512
Name:LEFEVRE, MELISSA (RN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:LEFEVRE
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 1:3 EMILY JEFFERS RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2831
Mailing Address - Country:US
Mailing Address - Phone:845-670-0363
Mailing Address - Fax:
Practice Address - Street 1:3 EMILY JEFFERS RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2831
Practice Address - Country:US
Practice Address - Phone:845-670-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2305086163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health