Provider Demographics
NPI:1528221306
Name:FOX, MELISSA D (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:FOX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 CARMIN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45427-2056
Mailing Address - Country:US
Mailing Address - Phone:937-520-8811
Mailing Address - Fax:
Practice Address - Street 1:6141 CARMIN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45427-2056
Practice Address - Country:US
Practice Address - Phone:937-520-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN338466163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse