Provider Demographics
NPI:1578899274
Name:CARMAN, MELISSA LEE (CPM, LICMIDWIFE)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEE
Last Name:CARMAN
Suffix:
Gender:F
Credentials:CPM, LICMIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1983 ELLISBURG RD
Mailing Address - Street 2:
Mailing Address - City:GENESEE
Mailing Address - State:PA
Mailing Address - Zip Code:16923-8824
Mailing Address - Country:US
Mailing Address - Phone:315-945-9693
Mailing Address - Fax:585-456-1962
Practice Address - Street 1:4651 RIDGE CHAPEL RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NY
Practice Address - Zip Code:14505-9641
Practice Address - Country:US
Practice Address - Phone:315-945-9693
Practice Address - Fax:315-331-3528
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife