Provider Demographics
NPI:1578784856
Name:HODGES, MELISSA EDITH (RN, MS, CNS)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:EDITH
Last Name:HODGES
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Gender:F
Credentials:RN, MS, CNS
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Mailing Address - Street 1:6350 LUNTSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE FINANCE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2337
Mailing Address - Country:US
Mailing Address - Phone:937-278-6251
Mailing Address - Fax:937-276-8248
Practice Address - Street 1:2222 PHILADELPHIA DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1813
Practice Address - Country:US
Practice Address - Phone:937-278-6251
Practice Address - Fax:937-276-8248
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHNS-01537364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health