Provider Demographics
NPI:1356853816
Name:HAYHURST, MELISSA KATHLEEN
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:KATHLEEN
Last Name:HAYHURST
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 1:103 N PHOENIX AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-8614
Mailing Address - Country:US
Mailing Address - Phone:505-340-6021
Mailing Address - Fax:
Practice Address - Street 1:1055 S HOUSTON AVE W
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9014
Practice Address - Country:US
Practice Address - Phone:918-921-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator