Provider Demographics
NPI:1568227288
Name:ALWERT, MELISSA J (RN BSN CCM)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:ALWERT
Suffix:
Gender:F
Credentials:RN BSN CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9508 N 109TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4390
Mailing Address - Country:US
Mailing Address - Phone:918-519-0744
Mailing Address - Fax:770-723-8860
Practice Address - Street 1:9508 N 109TH EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4390
Practice Address - Country:US
Practice Address - Phone:918-519-0744
Practice Address - Fax:770-723-8860
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0064862163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management