Provider Demographics
NPI:1568118149
Name:PIPER, MELISSA A (LPN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:PIPER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:WYMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9747 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:DOWLING
Mailing Address - State:MI
Mailing Address - Zip Code:49050-7701
Mailing Address - Country:US
Mailing Address - Phone:269-908-2862
Mailing Address - Fax:
Practice Address - Street 1:9747 NORTH AVE
Practice Address - Street 2:
Practice Address - City:DOWLING
Practice Address - State:MI
Practice Address - Zip Code:49050-7701
Practice Address - Country:US
Practice Address - Phone:269-908-2862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703125998251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care