Provider Demographics
NPI:1386652477
Name:BADALI, MELODY (RN)
Entity Type:Individual
Prefix:MR
First Name:MELODY
Middle Name:
Last Name:BADALI
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 1:50 E STATE ST
Mailing Address - Street 2:PO BOX 618
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2343
Mailing Address - Country:US
Mailing Address - Phone:801-451-3315
Mailing Address - Fax:801-451-3369
Practice Address - Street 1:50 E STATE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2343
Practice Address - Country:US
Practice Address - Phone:801-451-3315
Practice Address - Fax:801-451-3369
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1951223102163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health