Provider Demographics
NPI:1407156730
Name:BAKER, MELISSA S (RPA/RA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:S
Last Name:BAKER
Suffix:
Gender:F
Credentials:RPA/RA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:S
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1421 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-3247
Mailing Address - Country:US
Mailing Address - Phone:662-335-0183
Mailing Address - Fax:662-335-7184
Practice Address - Street 1:1400 E UNION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-3246
Practice Address - Country:US
Practice Address - Phone:662-207-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT07MS1279243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant