Provider Demographics
NPI:1467179127
Name:MORALES, MELINDA MARIE
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:MARIE
Last Name:MORALES
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 1:222 HIGH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5441
Mailing Address - Country:US
Mailing Address - Phone:817-704-8243
Mailing Address - Fax:
Practice Address - Street 1:222 HIGH ST APT 8
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5441
Practice Address - Country:US
Practice Address - Phone:817-704-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant