Provider Demographics
NPI:1467232215
Name:BAILEY, MELINDA RENEE
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:RENEE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:RENEE
Other - Last Name:SEXTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:326 BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-2281
Mailing Address - Country:US
Mailing Address - Phone:580-850-3579
Mailing Address - Fax:
Practice Address - Street 1:326 BRIAR CT
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2281
Practice Address - Country:US
Practice Address - Phone:580-850-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist