Provider Demographics
NPI:1497440242
Name:ESPINOZA, MELODY EMILYMAY
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:EMILYMAY
Last Name:ESPINOZA
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 1:909 OLYMPIC AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8434
Mailing Address - Country:US
Mailing Address - Phone:541-218-5386
Mailing Address - Fax:
Practice Address - Street 1:1301 W STEWART AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-4705
Practice Address - Country:US
Practice Address - Phone:541-261-8061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide