Provider Demographics
NPI:1467191759
Name:FLUHARTY, MELISSA DAWN
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:FLUHARTY
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 1:49 MARKS MNR
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:WV
Mailing Address - Zip Code:26160-8494
Mailing Address - Country:US
Mailing Address - Phone:304-893-7656
Mailing Address - Fax:
Practice Address - Street 1:49 MARKS MNR
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:WV
Practice Address - Zip Code:26160-8494
Practice Address - Country:US
Practice Address - Phone:304-893-7656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant