Provider Demographics
NPI:1356465520
Name:KIEFFNER, MELISSA ELIZABETH
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ELIZABETH
Last Name:KIEFFNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-2629
Mailing Address - Country:US
Mailing Address - Phone:870-217-1197
Mailing Address - Fax:870-217-1197
Practice Address - Street 1:1203 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-2629
Practice Address - Country:US
Practice Address - Phone:870-217-1197
Practice Address - Fax:870-217-1197
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SP2137235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist