Provider Demographics
NPI:1437745098
Name:POWELL, MELISSA JANE
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JANE
Last Name:POWELL
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 1:1601 THOMPSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:OTWAY
Mailing Address - State:OH
Mailing Address - Zip Code:45657-9089
Mailing Address - Country:US
Mailing Address - Phone:740-372-2800
Mailing Address - Fax:
Practice Address - Street 1:1787 THOMPSON HILL RD
Practice Address - Street 2:
Practice Address - City:OTWAY
Practice Address - State:OH
Practice Address - Zip Code:45657-9089
Practice Address - Country:US
Practice Address - Phone:740-372-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant