Provider Demographics
NPI:1467729517
Name:KAUDER, MELISA LYNN
Entity Type:Individual
Prefix:MRS
First Name:MELISA
Middle Name:LYNN
Last Name:KAUDER
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 1:101 CARTER RD
Mailing Address - Street 2:HIGH SCHOOL HEALTH OFFICE
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1053
Mailing Address - Country:US
Mailing Address - Phone:315-781-4164
Mailing Address - Fax:315-781-0378
Practice Address - Street 1:101 CARTER RD
Practice Address - Street 2:HIGH SCHOOL HEALTH OFFICE
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1053
Practice Address - Country:US
Practice Address - Phone:315-781-4164
Practice Address - Fax:315-781-0378
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY548046-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool