Provider Demographics
NPI:1417396540
Name:CRAVEN, MELISSA RENE (RRT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:RENE
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:HANAHAN
Mailing Address - State:SC
Mailing Address - Zip Code:29410-2020
Mailing Address - Country:US
Mailing Address - Phone:843-789-7925
Mailing Address - Fax:
Practice Address - Street 1:6312 MURRAY DR
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-2020
Practice Address - Country:US
Practice Address - Phone:843-789-7925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC379182279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2278H0200XOtherVA HEALTH ADMINISTRATION